Anabolic effects of oxandrolone after severe burn.
OBJECTIVE
To explore the hypothesis that oxandrolone may reverse muscle catabolism in cachectic, critically ill pediatric burn patients.


BACKGROUND
Severe burn causes exaggerated muscle protein catabolism, contributing to weakness and delayed healing. Oxandrolone is an anabolic steroid that has been used in cachectic hepatitis and AIDS patients.


METHODS
Fourteen severely burned children were enrolled during a 5-month period in a prospective cohort analytic study. There was a prolonged delay in the arrival of these patients to the burn unit for definitive care. This neglect of skin grafting and nutritional support resulted in critically ill children with significant malnutrition. On arrival, all patients underwent excision and skin grafting and received similar clinical care. Subjects were studied 5 to 7 days after admission, and again after 1 week of oxandrolone treatment at 0.1 mg/kg by mouth twice daily or no pharmacologic treatment. Muscle protein kinetics were derived from femoral arterial and venous blood samples and vastus lateralis muscle biopsies during a stable isotope infusion.


RESULTS
Control and oxandrolone subjects were similar in age, weight, and percentage of body surface area burned. Muscle protein net balance decreased in controls and improved in the oxandrolone group. The improvement in the oxandrolone group was associated with increased protein synthesis efficiency. Muscle protein breakdown was unchanged.


CONCLUSIONS
In burn victims, oxandrolone improves muscle protein metabolism through enhanced protein synthesis efficiency. These findings suggest the efficacy of oxandrolone in impeding muscle protein catabolism in cachectic, critically injured children.
Hart
D W
DW
Department of Surgery, The University of Texas Medical Branch and the Shriners Hospitals for Children, Galveston, Texas, USA.
Wolf
S E
SE
Ramzy
P I
PI
Chinkes
D L
DL
Beauford
R B
RB
Ferrando
A A
AA
Wolfe
R R
RR
Herndon
D N
DN
D045930:Anabolic Agents / Q000627:therapeutic use*; D002056:Burns / Q000188:drug therapy* / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D009124:Muscle Proteins / Q000378:metabolism*; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000378:metabolism; D009752:Nutritional Status; D010074:Oxandrolone / Q000627:therapeutic use*; D011446:Prospective Studies; D016038:Skin Transplantation; D013997:Time Factors
D045930:Anabolic Agents; D009124:Muscle Proteins; D010074:Oxandrolone