Biosynthetic human growth hormone in burned patients: a pilot study

A 15-day, open trial was conducted in 12 adult burned patients of whom six were randomly allocated to form a control group and six to receive biosynthetic human growth hormone (somatropin). All were fed enterally and treated according to a standard burn protocol. The mean age, burn size, energy and nitrogen intakes were well matched in each group. The resting energy expenditures (REE) were comparable in each group and the REEs exceeded the calculated basal energy expenditures by a mean of 36.8 ± 4.1 per cent for both groups. Blood urea values were significantly lower in somatropin-treated patients but there was no significant difference in nitrogen balance, protein oxidation or the rate of plasma protein recovery between the two groups. The basal plasma insulin concentration and basal insulinogenic index were significantly higher in somatropin-treated patients but insulin release, in response to injected glucose, was comparable in both groups. All patients had impaired glucose disposal due to insulin resistance but the area under the glucose curve increased significantly during somatropin treatment. It is concluded that somatropin administration did not significantly improve nutrition in burned patients but has been shown to exacerbate the existing insulin resistance.