Oxandrolone in trauma patients

Study Objective. To determine the effect of oxandrolone administration on n utritional and clinical outcomes after multiple trauma. Design. Prospective, randomized, double-blind, placebo-controlled study. Setting. Level 1 trauma center in a university teaching hospital. Patients. Sixty-two patients requiring enteral nutrition, 60 of whom comple ted the study. Intervention. Patients were randomized to receive either oxandrolone 10 mg or placebo twice/day for a maximum of 28 days. Measurements and Main Results. Total urinary nitrogen, prealbumin, nitrogen balance, total body water, and body cell mass were measured on day 1 of en teral nutrition and then at day 7, day 10, and study exit. Patients were as sessed daily for metabolic and infectious complications. The two groups wer e similar for demographics and dosage of enteral nutrition. Measurement of total urinary nitrogen at study entry showed both groups to be highly catab olic (oxandrolone 17.2 +/- 4.9, placebo 19.1 +/- 10.8 g/day, NS). On days 7 and 10, total urinary nitrogen increased in both groups; however, there wa s no significant difference between groups. Nitrogen balance was negative t hroughout the study in each group. Body cell mass decreased slightly in bot h groups over the study period. Prealbumin serum concentrations increased s ignificantly in both groups at day 10 and study exit compared with study en try. The groups did not differ significantly for length of hospital stay (o xandrolone 30.8 +/- 17.9, placebo 27.0 +/- 25.7 days), length of intensive care unit stay (oxandrolone 17.1 +/- 7.8, placebo 15.5 +/- 9.7 days), and f requency of pneumonia or sepsis (oxandrolone 48, placebo 43 episodes). Conclusion. Oxandrolone 20 mg/day does not have obvious benefit in nutritio nal and clinical outcomes during the first month after multiple trauma.