ANABOLIC AND CARDIOVASCULAR EFFECTS OF RECOMBINANT HUMAN GROWTH-HORMONE IN SURGICAL PATIENTS WITH SEPSIS

The clinical and metabolic effects of 7 days of recombinant human grow th hormone (rhGH) and total parenteral nutrition (TPN) in surgical pat ients with sepsis were determined in a randomized controlled trial. In patients with a mean(s.e.m.) pretreatment rate of net protein catabol ism (NPC) of 1.5 g per kg per day or less rhGH treatment decreased NPC from 0.93(0.14) to -0.20(0.24) g per kg per day (n = 5; P < 0.0005) a nd rendered these patients anabolic. TPN alone decreased NPC from 1.12 (0.11) to 0.61(0.11) g per kg per day (n = 5; P < 0.001). In patients with an initial NPC of more than 1.5 g per kg per day rhGH treatment d ecreased NPC from 2.72(0.12) to 1.08(0.24) g per kg per day (n = 5; P < 0.001) while TPN alone decreased it from 2.41(0.32) to 1.28(0.28) g per kg per day (n = 5; P < 0.005). Use of rhGH was not associated with any adverse effects or improvement in clinical course but did decreas e the mean systolic and diastolic pressures during the study period. T hus rhGH is a useful anabolic agent and may have a role in the haemody namic management of the catabolic patient with sepsis.