ABSTRACT
PURPOSE: Severe burn injury produces a catabolic state and several studies have evaluated the efficacy of recombinant human growth hormone (rhGH, GH) in burn treatment. This study aimed to investigate whether GH administration in severely burned patients can reverse or attenuate the catabolic state and can increase the serum level of insulin-like growth factor-I (IGF-I). The study also evaluated the efficacy of the early use of GH in major burn patients. METHODS: A randomized, controlled trial was carried out with 39 patients with severe burns (more than 40% of the total body surface burned or more than 20% full-thickness burns), of whom 24 completed the study protocol and were analysed. Fourteen patients received standard conservative treatment only, while the other 10 additionally received GH (0.1 mg/kg/day) over 3 weeks. Urinary urea nitrogen (UUN), transferrin, total body surface area burned (TBSAB) and IGF-I were measured. RESULTS: Additional GH treatment resulted in a significantly changed ratio (%) of UUN (P=0.010, P=0.011) and transferrin (P=0.012, P=0.031) at 1 week and 2 weeks, compared to no-GH treatment. These parameters showed significant change during the study period within the GH group. Furthermore, GH treatment showed a 3-fold elevation in IGF-I, while no-GH treatment did not show any significant change (P=0.021). TBSAB was decreased significantly in GH treatment compared to no-GH treatment at 2 weeks (P=0.046), but there was no significant difference at 1 week and 3 weeks. CONCLUSION: These results indicate that GH attenuates thecatabolic state and that short-term GH treatment in addition to standard burn treatment appears to have benefits for severely burned patients.