title: Effects of recombinant human growth hormone in patients with severe sepsis.
abstract: The objective of this study was to evaluate the safety and the effect of recombinant exogenous growth hormone (GH) on nitrogen production in patients with severe sepsis. It was designed as a prospective, randomized, placebo-controlled trial, and performed in the medical intensive care unit of a university hospital. Twenty patients admitted with septic shock and receiving standard parenteral nutrition served as subjects. Treatment consisted of GH 0.1 mg/kg/day or placebo administered as continuous intravenous infusion on the second, third, and fourth days after admission. The study period was eight days. During GH administration, nitrogen production decreased significantly in the GH group and increased in controls (p < 0.01). Nitrogen balance became slightly positive in the GH group during treatment: 1.2 +/- 6.4 versus controls -3.7 +/- 3.8 g/day (day 3) (p < 0.05). Within 24 hours after cessation of treatment, differences between GH and controls disappeared. 3-Methylhistidine excretion as a measure of absolute muscle breakdown declined during the study period, but did not differ between groups. The levels of insulin, insulinlike growth factor 1, glycerol, free fatty acids, and beta-hydroxybutyrate increased during treatment. Despite continuous intravenous administration, GH levels gradually declined during the 3 treatment days, indicating increased metabolic clearance. Side effects other than insulin resistance were not observed. Growth hormone administration reduces nitrogen production and improves nitrogen balance in patients with severe sepsis. These effects are not sustained after cessation of treatment.
authors: Medical Intensive Care Unit, Free University Hospital, Amsterdam, The Netherlands.
authors: H J
authors: HJ
authors: Voerman
authors: R J
authors: RJ
authors: van Schijndel
authors: A B
authors: AB
authors: Groeneveld
authors: H
authors: H
authors: de Boer
authors: J P
authors: JP
authors: Nauta
authors: E A
authors: EA
authors: van der Veen
authors: L G
authors: LG
authors: Thijs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D005260:Female; D013006:Growth Hormone / Q000009:adverse effects / Q000627:therapeutic use*; D006728:Hormones / Q000378:metabolism; D006801:Humans; D007239:Infections / Q000378:metabolism / Q000628:therapy*; D050356:Lipid Metabolism; D008297:Male; D008762:Methylhistidines / Q000652:urine; D008875:Middle Aged; D009584:Nitrogen / Q000378:metabolism; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D006728:Hormones; D008762:Methylhistidines; D011994:Recombinant Proteins; D013006:Growth Hormone; C028118:3-methylhistidine; D009584:Nitrogen