Troubles hypophysaires chez les victimes de traumatisme craniocérébral admises à l'unité des soins intensifs

 

François Lauzier

Centre de recherche du CHA - Hôpital de l'Enfant-Jésus

 

Domaine : neurosciences, santé mentale et toxicomanies

Programme chercheurs-boursiers cliniciens - Junior 2

Concours 2014-2015

Damage to the pituitary gland, located at the base of the brain, is a frequently overlooked but potentially important complication of traumatic brain injury (TBI) that can cause dysfunction of the thyroid, adrenals, ovaries and testes. Pituitary disorders may occur immediately or several months after TBI and may contribute to symptoms commonly experienced by TBI survivors such as fatigue, poor concentration, depression and low exercise capacity. However, the association between pituitary disorders and disability in TBI remains uncertain. Our first objective is to better understand the epidemiology of pituitary disorders among victims of TBI admitted to the intensive care unit (ICU).

We will initially perform a pilot study on 70 patients to assess the feasibility of a larger study that will evaluate the impact of pituitary disorders on neurological disability, functional recovery, quality of life and depression. The larger study will include 246 patients in 15 centers across Canada. Each patient will undergo hormonal and outcome assessment in the ICU, prior to hospital discharge, at 6 and 12 months. We will collect data on baseline characteristics, trauma severity, and interventions used to care for each patient. Our second objective is to describe the current practice of physicians caring for TBI patients regarding the screening and treatment of pituitary disorders.

Therefore, we will survey ICU physicians, endocrinologists and rehabilitation physicians across Canada. Our research projects will provide key findings of the impact of pituitary disorders following TBI, which is a mandatory step prior testing the efficacy of hormonal therapy in this population with costly trials. The results of our survey will allow moving forward rapidly with the design and conduct of high-quality trials. Otherwise, if no relationship between pituitary disorders and disability is observed, our findings will prevent unnecessary, time-consuming and costly hormonal screening and will discourage potentially harmful hormonal therapy.