Beneficial effects of extended growth hormone treatment after hospital discharge in pediatric burn patients.
OBJECTIVE
To study the efficacy of growth hormone given to severely burned children from discharge to 12 months after burn and for 12 months after the drug was discontinued.


BACKGROUND
We have previously shown that low-dose recombinant human growth hormone (rhGH), given to children after a severe thermal injury, successfully improved lean muscle mass, bone mineral content, and growth. The aim of the present study was to investigate long-term functional improvements after treatment.


METHODS
Forty-four pediatric patients with over 40% total body surface area burns were studied for 24 months after burn. Patients were randomized to receive either rhGH (0.05 mg/kg body weight) or placebo. Height, weight, body composition, serum hormones, resting energy expenditure, cardiac function, muscle strength, and number of reconstructive procedures performed were measured during rhGH treatment and for 12 months after treatment was discontinued. Statistical analysis used Tukey's multiple comparison test. Significance was accepted at P < 0.05.


RESULTS
Height, weight, lean body mass, bone mineral content, cardiac function, and muscle strength significantly improved during rhGH treatment compared with placebo (P < 0.05). This treatment significantly increased GH, IGF-I, and IGFBP-3, whereas serum cortisol decreased (P < 0.05). The number of operative reconstructive procedures was significantly lower with rhGH (P < 0.05). Improvements in height, bone mineral content, and IGF-1 concentrations persisted after rhGH treatment (P < 0.05). No side effects with rhGH were observed.


CONCLUSIONS
Administration of rhGH for 1 year after burn was safe and improved recovery. These salutary effects continued after rhGH treatment was discontinued.
Przkora
Rene
R
Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children, 815 Market Street, Galveston, TX 77550, USA.
Herndon
David N
DN
Suman
Oscar E
OE
Jeschke
Marc G
MG
Meyer
Walter J
WJ
Chinkes
David L
DL
Mlcak
Ronald P
RP
Huang
Ted
T
Barrow
Robert E
RE
D002056:Burns / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010045:Outpatients; D010351:Patient Discharge; D011994:Recombinant Proteins / Q000627:therapeutic use*; D012189:Retrospective Studies; D013997:Time Factors; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects
D011994:Recombinant Proteins; D019382:Human Growth Hormone