Growth factors in clinical practice

Growth factors enhance protein synthesis and thus reduce the catabolic resp onse to injury. As a result of bioengineering and new manufacturing techniq ues several anabolic agents have become available for clinical use and have been evaluated in surgical patients with catabolic illness. Data support t he anabolic effects of growth home in such patients, but its expense and po ssible deleterious effects during the acute phase of illness limit its use to selected patient groups. Insulin-like growth factor-1 has also been stud ied, but specific indications for its use have not been identified in catab olic patients. Testosterone and derivatives of this hormone exert anabolic effects, but few randomized trials include catabolic surgical patients, and higher doses of some derivative compounds are associated with hepatic dysf unction. Nonetheless, as we move into the future, studies will determine th e specific doses for administration of these and other anabolic factors in specific patient groups. Anabolic therapy will shorten the length of therap y and improve the outcome in the future.