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

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