Effects of Recombinant Human Growth Hormone on Nitrogen Balance in Patients with Sepsis

Koh, J M; Chae, H B; Park, J Y; Kim, J Y; Kim, C H; Choi, C S; Kim, Y S; Lim, C M; Koh, Y S; Lee, K U; Kim, G S

Abstract

BACKGROUND: Increased catabolism in patients with severe sepsis results in loss of body protein, which is associated with loss of skeletal muscle, impaired immune function and delayed wound healing. However, conventional nutritional support has been unsuccessful in inducing a positive nitrogen balance in septic patient. Recently, growth hormone (GH) has been reported to improve the nitrogen balance in patients with burns and multiple trauma.
METHODS
As a prospective, randomized, placebo-controlled trial, we studied the effects of 8 day treatment of recombinant human GH(rhGH) on nitrogen balance in patients with sepsis. Twenty four patients with sepsis admitted to medical intensive care unit from July, 1993 to June, 1995 were divided into GH-group(n=13) and control group(n=11). RhGH (EutropinR, Lucky) 0.4IU/kg or same volume of saline was administered once daily as subcutaneous injection for 8 days.
RESULTS
Twenty one patients((H group; 12, control group; 9) completed the study. Nitrogen balance was negative on day O, but became positive on day 2 and remained positive throughout the study period in the GH group. Mean nitrogen production rate [nitrogen excretion rate(g/day+deltaBUN(mmol/L/day) X 0.019 X body weight(kg)) was significantly lower in GH group than that in control group(12.8+/-3.9g/day vs. 16.8+/-4.1g/day p<0.05).
CONCLUSION
GH treatment improved nitrogen balance in patients with severe sepsis and this improvement was associated with a decrease in nitrogen production rate. These results suggest that GH administration may be beneficial in nutritional sup- port for patients with severe sepsis.