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document
Dexamethasone therapy and cortisol excretion in severe pediatric head injury . Glucocorticoids are used in an attempt to reduce brain edema secondary to head injury . Nevertheless , their usefulness remains uncertain and contradictory . In a randomized study of 24 children with severe head injury , urinary free cortisol was measured by radioimmunoassay . Twelve patients ( group 1 ) received dexamethasone and 12 ( group 2 ) did not . All patients were treated with a standardized regimen . In group 1 there was complete suppression of endogenous cortisol production . In group 2 free cortisol was up to 20-fold higher than under basal conditions and reached maximum values on days 1-3 . Since the excretion of cortisol in urine reflects the production rate closely and is not influenced by liver function and barbiturates , the results in group 2 show that the endogenous production of steroids is an adequate reaction to severe head injury . Exogenous glucocorticoids are thus unlikely to have any more beneficial effects than endogenous cortisol .
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Intervention_Pharmacological
Dexamethasone therapy
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Intervention_Pharmacological
Glucocorticoids
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Intervention_Pharmacological
dexamethasone
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Intervention_Pharmacological
cortisol
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Outcome_Other
suppression of endogenous cortisol production
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Outcome_Physical
excretion of cortisol in urine