Recombinant human growth hormone for treating burns and donor sites

Breederveld, R.S.; Tuinebreijer, W.E.

doi:10.1002/14651858.cd008990.pub2

Cited by 17 publications

(17 citation statements)

References 46 publications

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“…no further growth potential can be expected. Stopping GH in the case of severe adverse effects, a severe illness or trauma is recommended [100][101][102] .…”

Section: Genetic Target Height Percentilementioning

confidence: 99%

Clinical practice recommendations for growth hormone treatment in children with chronic kidney disease

et al. 2019

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In the past two decades, major progress has been made in our understanding of the pathophysiology and treatment of growth failure in children with chronic kidney disease (CKD). Nevertheless, approximately 40% of children with end-stage renal disease (ESRD) have a reduced final height (below the third percentile) compared with that of healthy age-matched and sex-matched controls 1,2. Short stature impairs quality of life, self-esteem and social rehabilitation and is associated with increased mortality 3-6. The aetiology of growth failure in CKD is multifactorial and includes intrauterine growth restriction, malnutrition, mineral and bone disorder (MBD), metabolic acidosis, loss of electrolytes and disturbances of the somatotropic and gonadotropic hormone axes (Fig. 1). In particular, advanced CKD is a state of growth hormone (GH) insensitivity, characterized by deficiency of functional insulin-like growth factor 1 (IGF1) 7. This GH insensitivity can be overcome by the administration of supraphysiological doses of recombinant human GH (abbreviated to GH hereafter), which stimulates IGF1 synthesis, normalizes somatomedin bioactivity, promotes longitudinal growth and likely improves adult height 8,9. Consequently, GH has been licensed for the treatment of CKD-induced growth failure in Europe, North America and many other high-income countries. However, other than a treatment algorithm proposed by members of a consensus conference held in 2003 (reF. 10) and a brief guidance from the Kidney Disease Outcomes

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“…no further growth potential can be expected. Stopping GH in the case of severe adverse effects, a severe illness or trauma is recommended [100][101][102] .…”

Section: Genetic Target Height Percentilementioning

confidence: 99%

Clinical practice recommendations for growth hormone treatment in children with chronic kidney disease

et al. 2019

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“…Clinically rhGH reduces hypercatabolism following burn injuries, speeding up protein synthesis, improving negative nitrogen balance, promoting burn wound and skin donor site healing, and shortens length of hospital stay, and its wide use in treating burn patients has been commonly recognized by physicians ( 12 , 13 ). Thus, rhGH is one of the options available for treatment of severe burns ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…Since most severely burned patients have an associated dysfunction in protein synthesis, rhGH can promote protein utilization and synthesis, and its curative effects have been widely recognized by clinicians. In addition, rhGH has also been recommended in the nutritional supporting guideline for burn patients in China ( 12 ), and a recent Cochrane review suggested that there was some evidence the rhGH could result in more rapid healing of severe burns ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial to compare the effects of liquid versus powdered recombinant human growth hormone in treating patients with severe burns

2016

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Recombinant human growth hormone (rhGH) promotes protein utilization and synthesis, and is widely used as a therapy to treat severe burns. The present randomized controlled trial evaluated the effects of different forms of rhGH on patients with severe burns. A total of 29 adult severe burns patients were enrolled between February 2009 and November 2011, and randomly assigned to either treatment group (T, liquid rhGH) or control group (C, powder rhGH). From days 5 to 7 following the infliction of burns, both patient groups received rhGH at 0.067 mg/kg/d, once for 10 days. Median serum pre-albumin levels increased in both groups following treatment, the elevation from baseline was significantly higher in the T group on day 10 compared to the C group (88 mg/l vs. 65 mg/l, P=0.046). C-reactive protein, fasting plasma glucose and body weight decreased in both groups. Body weight was significantly lower in the T compared to the C group at baseline, Day 5 and Day 10 (P=0.046, P=0.018 and P=0.006, respectively), however the decrease from baseline levels were not significantly different. Wound healing time was similar between groups (P=0.270). In conclusion the early use of liquid rather than powder rhGH may be more beneficial for treating adult patients with severe burns.

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“…280 Recombinant human growth hormone (somatropin) provides a clinically significant beneficial effect on healing time and LOS with a side effect of increased incidence of hyperglycemia. 281 Hyperglycemia from insulin insensitivity is a well-established acute complication of severe burns and it should be avoided as it is associated with a risk of infection, catabolism, and excessive inflammation. 282 Insulin controls hyperglycemia effectively in patients with burns.…”

Section: Perioperative Managementmentioning

confidence: 99%

A Critical Update of the Assessment and Acute Management of Patients with Severe Burns

Lang

Zhao²,

Kim

et al. 2019

Advances in Wound Care

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Burns are debilitating, life threatening, and difficult to assess and manage. Recent advances in assessment and management have occurred since a comprehensive review of the care of patients with severe burns was last published, which may influence research and clinical practice. Recent Advances: Recent advances have occurred in the understanding of burn pathophysiology, which has led to the identification of potential biomarkers of burn severity, such as protein C. There is new evidence about the potential superiority of natural colloids over crystalloids during fluid resuscitation, and new evidence about components of initial and perioperative management, including an improved understanding of pain following burns. Critical Issues: The limitations of the clinical examination highlight the need for imaging and biomarkers to assist in estimations of burn severity. Fluid resuscitation reduces mortality, although there is conjecture over the ideal method. The subsequent perioperative period is associated with significant morbidity and the evidence for preventing and treating pain, infection, and fluid overload while maximizing wound healing potential is described. Future Directions: Promising developments are ongoing in imaging technology, histopathology, biomarkers, and wound healing adjuncts such as hyperbaric oxygen therapy, topical negative pressure therapy, stem cell treatments, and skin substitutes. The greatest benefit from further research on management of patients with burns would most likely be derived from the elucidation of optimal fluid resuscitation protocols, pain management protocols, and surgical techniques from randomized controlled trials.

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Recombinant human growth hormone for treating burns and donor sites

Cited by 17 publications

References 46 publications

Clinical practice recommendations for growth hormone treatment in children with chronic kidney disease

Clinical practice recommendations for growth hormone treatment in children with chronic kidney disease

A randomized controlled trial to compare the effects of liquid versus powdered recombinant human growth hormone in treating patients with severe burns

A Critical Update of the Assessment and Acute Management of Patients with Severe Burns

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