THE EFFECT OF GROWTH-HORMONE ON NUTRITIONAL MARKERS IN ENTERALLY FED IMMOBILIZED TRAUMA PATIENTS

Background: Earlier clinical studies have demonstrated improved nitrog en balance in nonstressed patients receiving hypocaloric feedings and growth hormone (GH). This study investigates the effect of GH on nitro gen balance, on serum protein concentrations, and on other indices of nutrition when combined with enteral feeding in immobilized patients a fter closed-head injury or spinal cord injury. Methods: Sixteen patien ts who tolerated enteral feedings and remained nonseptic were randomiz ed to receive either placebo or 0.2 mg/kg recombinant human GH for 7 t o 13 days. Nitrogen balances were collected daily, and serum proteins were measured at study entrance and exit. Results: GH treatment result ed in higher GH and insulin-like growth factor-1 concentrations but di d not improve nitrogen balance. GH treatment also resulted in increase d transferrin and serum albumin levels and total lymphocyte count duri ng the study period. Conclusions: Adjuvant recombinant human GH has no effect on nitrogen balance in highly stressed, totally immobilized pa tients after head or spinal cord injury, but it significantly enhances constitutive serum protein concentrations and other indices of nutrit ional repletion.