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. 2001 Apr;233(4):556-64.
doi: 10.1097/00000658-200104000-00012.

Anabolic Effects of Oxandrolone After Severe Burn

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Free PMC article

Anabolic Effects of Oxandrolone After Severe Burn

D W Hart et al. Ann Surg. .
Free PMC article

Abstract

Objective: To explore the hypothesis that oxandrolone may reverse muscle catabolism in cachectic, critically ill pediatric burn patients.

Summary background data: Severe burn causes exaggerated muscle protein catabolism, contributing to weakness and delayed healing. Oxandrolone is an anabolic steroid that has been used in cachectic hepatitis and AIDS patients.

Methods: Fourteen severely burned children were enrolled during a 5-month period in a prospective cohort analytic study. There was a prolonged delay in the arrival of these patients to the burn unit for definitive care. This neglect of skin grafting and nutritional support resulted in critically ill children with significant malnutrition. On arrival, all patients underwent excision and skin grafting and received similar clinical care. Subjects were studied 5 to 7 days after admission, and again after 1 week of oxandrolone treatment at 0.1 mg/kg by mouth twice daily or no pharmacologic treatment. Muscle protein kinetics were derived from femoral arterial and venous blood samples and vastus lateralis muscle biopsies during a stable isotope infusion.

Results: Control and oxandrolone subjects were similar in age, weight, and percentage of body surface area burned. Muscle protein net balance decreased in controls and improved in the oxandrolone group. The improvement in the oxandrolone group was associated with increased protein synthesis efficiency. Muscle protein breakdown was unchanged.

Conclusions: In burn victims, oxandrolone improves muscle protein metabolism through enhanced protein synthesis efficiency. These findings suggest the efficacy of oxandrolone in impeding muscle protein catabolism in cachectic, critically injured children.

Figures

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Figure 1. Study design. This study comprised nutritionally depleted children burned over 20% total body surface area who were at least 1 week removed from injury. Burn wounds were totally excised and grafted within 48 hours of admission. After 5 days, a baseline muscle protein kinetic study was done. After the second serial grafting procedure, patients in the control and drug groups underwent a 5-day treatment period and then were studied again.
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Figure 2. Five-hour isotope infusion protocol. Beginning between 5 and 7 am, subjects in the continuously fed state were infused with a prime-constant d5-phenylalanine isotope. Indocyanine green dye concentration was measured between hours 3 and 4 to determine leg blood flow. Femoral arteriovenous sampling during the fifth hour measured cross-leg phenylalanine balance. Muscle biopsies were performed at 2 and 5 hours while subjects were under intravenous conscious sedation.
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Figure 3. Model calculations of protein synthesis, protein breakdown, and net balance for seven oxandrolone and seven control patients. †P < .05 vs. baseline; ‡P < .01 vs. baseline; * P < .05 vs. time control (treatment period).

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