Severe
burn injury elicits the release of catabolic
hormones that contribute to negative
nitrogen balance,
protein wasting, and impaired wound healing. Previous studies have shown that
burn patients receiving recombinant
human growth hormone (rhGH)
therapy have an increase in the rate of skin donor site healing and a shorter
hospital stay. The mechanism by which rhGH exerts its effects, however, is not clearly understood. This study examines the effects of rhGH on circulating levels of catabolic
hormones and
nonesterified fatty acids in pediatric
burn patients. Patients with greater than 40% total body surface area
burn were randomly assigned to receive placebo (n = 8) or 0.2 mg/kg/day rhGH (n = 6) throughout their hospitalization. All patients had early morning blood samples assessed for
catecholamines (CAT),
cortisol,
insulin,
glucagon, and
free fatty acid (FFA) levels during a period of hypermetabolism. No differences could be demonstrated in age,
burn size, postburn day of evaluation, resting energy expenditure per kilogram, respiratory rate, heart rate, respiratory quotient, serum
cortisol, and serum
glucose between placebo- and rhGH-treated patients. The rhGH-treated group did show a significant elevation (p less than 0.05) in
insulin-like growth factor-1 (55.9 +/- 14.5 vs. 168 +/- 23.7 mU/mL), total
catecholamines (1,817 +/- 177 vs. 1,117 +/- 137 pg/mL),
norepinephrine (1,257 +/- 121 vs. 867 +/- 113 pg/mL),
epinephrine (385 +/- 175 vs. 147 +/- 36 pg/mL),
insulin (32.8 +/- 3.3 vs. 25.0 +/- 3.0 mU/mL),
glucagon (215 +/- 18 vs. 158 +/- 22 pg/mL), and
free fatty acids (0.74 +/- 0.01 vs. 0.59 +/- 0.04 mEq/L) compared with the placebo group (data expressed as mean +/- SE).(ABSTRACT TRUNCATED AT 250 WORDS)