ESPE Abstracts

Objective: Hospitalization in pediatric intensive care unit due to critical illness may be life threatening condition associated with severe acute physical stress and concomitant hormonal changes. Whether these changes represent an adaptive response or need to be treated is still not known.

Methods: Pituitary hormones evaluation in four patients who were hospitalized in pediatric intensive care unit due to different severe diseases accompanied by transient multiple pituitary hormone deficiency.

Results: The most common pituitary hormones alterations included deficiency of growth hormone axis, gonadotropins and thyroid stimulating hormone, but other pituitary hormones may be involved as well. Anterior pituitary hormonal function fully recovered within 10-14 days, without administration of hormonal replacement treatment. If posterior pituitary was also involved (i.e. transient deficiency or over secretion of anti-diuretic hormone), fluid restriction or a short treatment with desmopressin was indicated. Despite high cortisol and low insulin growth factor-1 levels, both predictors of poor intensive care unit outcome, all our patients recovered.

Conclusions: Hospitalization in pediatric intensive care unit due to severe critical illness may be accompanied by transient multiple pituitary hormone deficiency ("sick pituitary syndrome"). Whether this reflects compensatory mechanism to preserve energy sources and therefore should not be treated, or whether pituitary hormone replacement treatment should be initiated when hormonal deficiencies persists for prolonged period requires further research.