ADJUVANT RECOMBINANT HUMAN GROWTH-HORMONE NORMALIZES PLASMA AMINO-ACIDS IN PARENTERALLY FED TRAUMA PATIENTS

Citation
M. Jeevanandam et al., ADJUVANT RECOMBINANT HUMAN GROWTH-HORMONE NORMALIZES PLASMA AMINO-ACIDS IN PARENTERALLY FED TRAUMA PATIENTS, JPEN. Journal of parenteral and enteral nutrition, 19(2), 1995, pp. 137-144
Citations number
32
Categorie Soggetti
Nutrition & Dietetics
ISSN journal
01486071
Volume
19
Issue
2
Year of publication
1995
Pages
137 - 144
Database
ISI
SICI code
0148-6071(1995)19:2<137:ARHGNP>2.0.ZU;2-R
Abstract
Background: The addition of an anabolic stimulant during intensive nut rition therapy in trauma patients seems to be a reasonable adjuvant fo r minimizing muscle-mass erosion. The plasma free amino acid pattern i s the mirror of the net amino acid metabolism, and we have measured th e progressive changes resulting from recombinant human growth hormone therapy in trauma victims during nutritional repletion in the early ca tabolic flow phase of injury. Methods: In 20 severely injured (injury severity scale = 31 +/- 2), highly catabolic, and hypermetabolic adult multiple-trauma patients, we have measured the fasting (day 0) plasma amino acid levels (48 to 60 hours after injury before starting the nu trition therapy) and their progressive changes during 7 days of IV nut rition support (total parenteral nutrition, 1.1 x resting energy expen diture calories, 250 mg of nitrogen per kilogram per day) with or with out adjuvant recombinant human growth hormone. Group H (n = 10) random ly received daily recombinant human growth horn-tone (0.15 mg of Somat ropin per kilogram per day) and Group C (n = 10) received the vehicle of infusion. Results: Hypoaminoacidemia of trauma is normalized by inf usion of recombinant human growth hormone, which indicates its anaboli c nature, and this is confirmed in the cumulative nitrogen balance (-2 81 +/- 139 mg of nitrogen per kilogram per 7 days compared with -809 /- 151 mg of nitrogen per Idiogram per 7 days without recombinant huma n growth hormone; p less than or equal to .005). This improved nitroge n retention is also reflected in the significantly low blood urea nitr ogen levels in the recombinant human growth hormone group, which repre sents the efficient utilization of the infused amino acids for synthes is of proteins. Elevated plasma insulin-like growth factor-1 levels in Group H compared with those in Group C may also account for this alte red amino acid metabolism. Conclusions: Recombinant human growth hormo ne treatment in combination with conventional total parenteral nutriti on in the immediate posttraumatic period improved nitrogen metabolism and normalized the plasma free amino acid levels.