Specialized Nutrition in Critically Ill Patients

Sherry A. Brown, PharmD, BCPS

Disclosures

November 30, 2001

In This Article

Anabolic Steroids

Testosterone and its analogues have been used to increase lean body mass and muscle strength in a variety of disease and nondisease states. In a study performed by Demling and coworkers[6] on the use of oxandrolone in patients with severe burn, a dosage of 20 mg/day was associated with a significant decrease in the amount of weight loss, a significant decrease in the net nitrogen loss, and an increase in the donor site wound healing. No complications were seen in the treated group. Compared with the older agents, oxandrolone is associated with fewer androgenic complications such as sodium and water retention, edema, lipid abnormalities, and virilizing effects.

Another study performed by Demling[7] in patients with severe burn found oxandrolone to be as effective as growth hormone in decreasing weight and nitrogen loss and increasing healing time of donor site. Furthermore, oxandrolone was associated with fewer adverse effects and lower cost.[7,8]

In a study performed by Gervasio and colleagues[9] involving 60 patients suffering from multiple trauma, oxandrolone at 20 mg/day compared with placebo showed no significant differences in the total length of stay, length of intensive care unit stay, and frequency of pneumonia or sepsis at 28 days. Dr. Gervasio stated that there is no obvious benefit seen in nutritional and clinical outcomes during the first month after multiple trauma. She concluded that oxandrolone should be considered only in thermally injured patients at this time due to the improved wound healing, increased rate of weight restoration, effectiveness as a growth hormone, and increased cost-effectiveness.

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