Nutritional, respiratory, and psychological effects of recombinant human growth hormone in patients undergoing abdominal aortic aneurysm repair

Background: Recombinant human growth hormone (rhGH) has been shown to have powerful anabolic effects and to reduce or even prevent nitrogen catabolism in stressed patients. The effects of rhGH on functional parameters are les s clearly defined. The aim of this study was to assess the effects of perio perative rhGH on nutritional markers, skeletal muscle function, and psychol ogical well-being in patients undergoing infrarenal, abdominal aortic aneur ysm repair. Methods: Thirty-three patients undergoing elective infrarenal a bdominal aortic aneurysm repair were randomized to one of three groups: (1) control (n = 12): placebo for 6 days before and after surgery; (2) preop postop (n = 10): rhGH (Genotropin; Pharmacia Ltd, Uppsala, Sweden) 0.3 IU/ kg/d for 6 days before and after surgery; and (3) postop (n = 11): placebo for 6 days before and rhGH 0.3 IU/kg/d for 6 days after surgery. Patients w ere assessed on days -7 and -1 before surgery and days 7, 14, and 60 after surgery. Results: Administration of rhGH resulted in increased insulinlike growth factor 1 levels, the increase being significantly more marked in the group given rhGH preoperatively. Preoperative and postoperative rhGH reduc ed the postoperative decrease in both serum transferrin and grip strength a t day 7 by 30% and 70%, respectively. Postoperative respiratory function an d arterial oxygenation also were improved, with significant differences in arterial oxygenation between rhGH-treated and untreated groups. No differen ce in mood was seen between groups after surgery, nor was there any differe nce between subjective assessment of fatigue scores between groups. Conclus ions: This pilot study indicates that rhGH administered preoperatively has beneficial effects on skeletal muscle and respiratory function and may be m ore useful than postoperative rhGH administration alone.