Long-Term Administration of Oxandrolone Improves Lung Function in Pediatric Burned Patients

Abstract

Pulmonary dysfunction is a significant contributor to morbidity and mortality in the pediatric burned population. We have previously reported that the administration of a synthetic testosterone derivative, oxandrolone, significantly reduced hypermetabolism, and significantly increased height percentile, bone mineral content, lean body mass, and strength in pediatric burned patients. Objective We hypothesize that the administration of oxandrolone will improve pulmonary function in burned pediatric subjects. Methods A subset of severely burned pediatric subjects from a prospective clinical trial (n=222) were included in our study (n=54, 7-18 years, ≥30% total body surface area burn). The subjects were previously randomized to either the control arm (n=35), or the oxandrolone arm (0.1 mg/kg twice/day for 12 months, n=19). Maximum voluntary ventilation (MVV), the ratio between forced expiratory volume and forced vital capacity, and diffusion capacity were measured six months following burn injury, and results were compared between burned subjects with and without oxandrolone administration. Maximum expired ventilation (VEMax) was also measured in a subset of burned subjects. Results Subjects treated with oxandrolone had a significantly higher MVV (98 ± 53 L/min vs 115 ± 56 with treatment, p=0.03). During maximal exercise, subjects treated with oxandrolone had a significantly higher VEMax compared to untreated subjects (32.0 ± 8.7 L/min vs 43.7 ± 13.6 with treatment, p=0.02). Conclusions The administration of oxandrolone was associated with improved lung function in pediatric burned patients.

Reduced Postburn Hypertrophic Scarring and Improved Physical Recovery With Yearlong Administration of Oxandrolone and Propranolol

“…26 Although the duration of oxandrolone administration in adults was short, in children, the long-term administration of oxandrolone for up to one year postburn improved lean mass, lung function, and both bone mineral density and bone mineral content. 27–2930 The benefits of long-term oxandrolone administration persisted well beyond the duration of therapy in severely burned children as well. 31,32…”

A review of the role of testosterone in the care of the critically ill patient

“…[61,62] Markers of lung function, such as maximum voluntary ventilation and maximum expired ventilation are also improved by long-term oxandrolone therapy. [63] Research in adult burn patients shows that oxandrolone, combined with adequate nutritional intake, reduces weight loss and daily nitrogen loss in the recovery phase of severe burn injuries by decreasing muscle protein breakdown. [64,65] It has also been demonstrated that oxandrolone improves the rehabilitation of these patients by increasing weight gain up to three times faster compared with nutritional support alone.…”

“…[51][52][53][54][55][56][57] In the recovery phase oxandrolone therapy, physical exercise and adequate nutritional intake have been shown to reverse growth arrest and improve both body composition and lung function. [59][60][61][62][63][64][65] Previous studies addressing the effect of testosterone on mechanical ventilation showed conflicting and statistically insignificant results. [51,56,57] No study has identified testosterone therapy alone as the solution to treat ICU-acquired weakness.…”

The P50 Research Center in Perioperative Sciences

“…Oxandrolone is a synthetic dihydrotestosterone derivative that, in the severely burned, decreases length of stay (58), improves lean body mass and muscle accretion (44, 58), increases bone mineral content and bone mineral density (45), enhances wound healing, accelerates growth rate (46), decreases the risk of osteoporosis (46), reduces protein breakdown (59), improves muscle strength (44), and improves lung function (48). In burned adults, administration of oxandrolone within 7 days of injury decreased mortality compared to untreated controls (60).…”