The changes of serum cortisol and its influence on prognosis in children with traumatic brain injury / 中国小儿急救医学

ABSTRACT

Objective To explore the changes of serum cortisol and its influence on prognosis in children with traumatic brain injury( TBI) . Methods A total of 52 children suffering from TBI hospitalized in SICU of Nanjing Children′s Hospital from June 2014 to December 2015 were analyzed. According to the glasgow coma scale(GCS),they were divided into three groupsmild injury group(19 cases,GCS≥13), moderate injury group(16 cases,8injury group(17 cases,GCS≤8). We collected the data of the following clinical parameters on the 1st,3rd,7th day after hospitalizationthe levels of serum adrenocorticotropic hormone ( ACTH) and cortisol,general vital signs,pediatric critical illness score,paedia-tric trauma score,cycle index( mean arterial pressure) ,metabolic index ( total protein,albumin,blood sugar) , respiratory index(pH,PaO2,PaO2/FiO2),ICU length of hospital stay,the total length of hospital stay,28 days case fatality rate. Results (1)There were significant differences in the scores of GCS,pediatric critical illness score,pediatric trauma score,heart rate,blood glucose and white blood cell count among three groups (P<0. 05). But the age,body weight,mean arterial pressure,pH,PaO2,PaO2/FiO2,total protein and albu-min showed no statistically significant difference(P<0. 05,respectively). (2)The levels of cortisol in chil-dren with TBI increased (24 hours) at early stage,and then gradually dropped to normal within one week.