Both
growth hormone (GH) and
insulin-like growth factor 1 (IGF-1) are potent
anabolic agents. Exogenous GH improves
nitrogen metabolism in patients undergoing surgery; however, the
anabolic effects of GH in cases of
multiple injury,
burn, and
sepsis are equivocal. Moreover, few data are available concerning the effects of GH in organ failures. Exogenous
IGF-1 attenuates catabolism in animal
trauma models. A clinical trial, however, did not confirm the anabolic actions of
IGF-1. Further knowledge of the interaction between the GH/IGF-1 axis in
critical illness is essential for GH and
IGF-1 therapy. Theoretically, the improved
nitrogen metabolism achieved with exogenous
anabolic agents may provide functional benefits. However, only a few studies have confirmed the beneficial effects of GH on body function in
trauma and
sepsis. GH treatment decreases the postoperative depression of hand grip strength. GH also stimulates wound healing. Both GH and
IGF-1 exert their effects on immune system, suggesting that these
anabolic agents are potentially beneficial for the prevention and treatment of
sepsis. On the contrary, inhibition of polymorphonuclear neutrophil apoptosis and the potentiation of PMNs by GH may have harmful effects on the systemic responses. Further studies are required to determine the safety and clinical benefits of GH administration in
critical illness.