Changes in relative pituitary hormones following severe traumatic brain injury in children and mild hypothermia treatment

Objective To observe changes in relative pituitary hormones after severe traumatic brain injury (STBI) in children and to investigate the short- and long-term effects of mild hypothermia on pituitary function. Methods Included for this study were 81 children who had been admitted to the Brain Hospital of Liaocheng People's Hospital from June 2011 to January 2015 for STBI and abnormal secretion of pituitary-related hormones. They were divided by the wishes of patients and their families into 2 groups, subjected to mild hypothermia treatment (n=42) or conventional treatment (n=41). The levels were examined of growth hormone (GH), prolactin (PRL), adrenocorticotropic hormone (ACTH), free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) for both groups unpon admission and in the morning of 1, 3, 5, 7 and 14 days after injury. At 6 months after injury the patients were followed up for Glasgow Outcome Score (GOS) and levels of pituitary-related hormones. Results Of the 83 patients, disturbance of one single hormone was found in 31 (30.10%) and disturbance of 2 or more hormones in 52 (50.48%). The top 3 hormones disturbed were PRL, ACTH and GH. On days 3, 5 and 7 after injury, the levels of PRL and ACTH in the mild hypothermia treatment group were significantly lower than in the conventional treatment group (P<0.05). On day 3 after injury, the level of FT3 in the mild hypothermia treatment group was significantly lower than in the conventional treatment group (P<0.05). At 6 months after injury, the GOS score for the conventional treatment group was 3.04±0.38, significantly lower than that for the mild hypothermia treatment group (4.56±0.62) (P< 0.05). The incidence of hypopituitarism in the hypothermia treatment group (16.67%) was significantly lower than in the conventional treatment group (46.88%) (P<0.05). Conclusions Incidence of pituitary dysfunction is high in children following severe traumatic brain injury. Mild hypothermia treatment can effectively alleviate early-stage parasecretion of pituitary hormones, and decrease the incidence of later pituitary dysfunction. Key words: Severe traumatic brain injury; Relative pituitary hormone; Mild hypothermia; Child