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Vol. 4. Issue 1.
Pages 63-66 (January 1993)
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Vol. 4. Issue 1.
Pages 63-66 (January 1993)
Función del eje hipotálamo-hipofisario en la muerte cerebral
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2021
J.M. Rabanal Llevot
Servicios de Anestesiología, Hospital Universitario «Marqués de Valdecilla». Santander
A. Vázquez Barquero*, J.R. Carda Llop*, J.M. Izquierdo Rojo*, J.A. Amado Señaris**
* Servicios de Neurocirugía, Hospital Universitario «Marqués de Valdecilla». Santander
** Servicios de Endocrinología. Hospital Universitario «Marqués de Valdecilla». Santander
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Resumen

La evolución de un paciente neurológico grave a la situación de muerte cerebral (MC) se produce como consecuencia de procesos que originan una isquemia cerebral generalizada con pérdida irreversible de todas las funciones encefálicas incluidas las troncoencefálicas. La isquemia del eje hipotálamo-hipofisario en la MC condicionaría un panhipopituitarismo universal que podría ser responsable del deterioro metabólico y hemodinámico de los donantes de órganos en MC.

Hemos realizado un estudio prospectivo en quince pacientes en MC en los que determinamos los niveles de hormonas hipofisarias y la incidencia de diabetes insípida, practicando también un test de la TRH. Los cambios endocrinos hallados ponen de manifiesto una insuficiencia hipofisaria bien anatómica o funcional tras la MC, con escasa reserva funcional para responder al estímulo de la TRH.

Palabras clave:
Hormonas hipofisarias
Muerte cerebral
Función endocrina
Hipofisis
Summary

Evolution to brain death of seriously ill neurologic patients is the consequence of cerebral isquemia. Isquemia of hypothalamic-hypophysis axis in brain death can be responsable of haemodynamic and metabolic disorders, in organ donors.

We performed a prospective study in fifteen brain death organ donors assesing hypophysis hormone leveIs and diabetes insipidus incidence. A TRH stimulation test was also performed.

The endocrine changes found in our study are characteristics of hypophyseal insufficiency (anatomic or functional), with little response to TRH stimulation.

Key words:
Pituitary hormones
Brain death
Endocrine function
Hypophysis

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