[Effects of short-term application of recombinant human growth hormone on urea production rate in patients in the early postoperative phase].
OBJECTIVE
To determine the effect of short-term recombinant human growth hormone (rhGH) administration on urea production rate (UPR), N balance and aminograms.


METHODS
Prospective, double-blind placebo-controlled study.


METHODS
Intensive care unit of a University Hospital.


METHODS
20 adult patients after major abdominal surgery.


METHODS
Postoperative substitution of rhGH (Saizen, Serono, Aubonne, CH) in a dose of 0.15 IE/kg BW for 3 days. The serum levels of hGH, insulin-like growth factor-1 (IGF-1), ACTH and cortisol were measured as well as the amino acids in plasma. The degree of catabolism was calculated according to Woolfson's formula, which is based on the UPR, and by calculation of the cumulative N balance.


RESULTS
With exception of proline, the plasma amino acids between the groups receiving active substance and total parenteral nutrition (TPN) and those receiving placebo and TPN did not differ significantly. Neither was there a significant difference between the groups for any other parameter measured. The UPR and IGF-1 levels showed only a tendency towards higher values as compared with the placebo group (UPR verum group, values in g/day: 1st measurement, 29.8 +/- 16.7; 2nd measurement, 28.3 +/- 17.7; 3rd measurement, 32.1 +/- 19.1; 4th measurement, 33.1 +/- 21.2. UPR placebo, values in g/day; 1st measurement, 32.6 +/- 23.9; 2nd measurement, 30.8 +/- 17.9; 3rd measurement 41.6 +/- 28.7; 4th measurement, 47.3 +/- 29.5. IGF-1 verum group, values in nmol/l; 1st measurement, 25.7 +/- 19.2; 2nd measurement, 44.8 +/- 23; 3rd measurement, 52.4 +/- 30; 4th measurement, 54.3 +/- 20. IGF-1 placebo, values in nmol/l; 1st measurement: 22.9 +/- 11.7; 2nd measurement, 37.0 +/- 19.4; 3rd measurement, 38.4 +/- 21.4; 4th measurement, 40.0 +/- 23.0). The ACTH-cortisol axis was only slightly depressed in the group receiving active substance.


CONCLUSIONS
We conclude that short-term rhGH administration over 3 days is not capable of significantly reducing the UPR in postoperative patients, but we cannot exclude a significant difference between rhGH group and placebo after a longer administration period.
Gottardis
M
M
Universitätsklinik für Anästhesie und Allgemeine Intensivmedizin, Innsbruck, Osterreich.
Gruber
E
E
Benzer
A
A
Murr
C
C
Schmoigl
C
C
Hackl
J M
JM
Balogh
D
D
D000005:Abdomen / Q000601:surgery*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D013006:Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009584:Nitrogen / Q000097:blood; D011183:Postoperative Complications / Q000097:blood*; D011184:Postoperative Period; D011994:Recombinant Proteins / Q000008:administration & dosage; D014508:Urea / Q000097:blood*
D011994:Recombinant Proteins; D007334:Insulin-Like Growth Factor I; D014508:Urea; D000324:Adrenocorticotropic Hormone; D013006:Growth Hormone; D009584:Nitrogen; D006854:Hydrocortisone