Current status of anabolic hormone administration in human burn injury

Survival after massive burns has increased due to advances in critical care and wound closure techniques. Because of the ravages of hypermetabolism that is so prevalent in these patients, survivors are left with significant lean body mass losses that correspond to decreased strength with which to begin the rehabilitation phase. Efforts to decrease lean body mass catabolism by environmental regulation, early wound closure, and sufficient caloric provision modify the hypermetabolic response to an extent; however, further manipulations are required to optimize recovery fully. Pharmacologic intervention with hormone agonists and antagonists holds this promise. This article reviews some of the current investigations in this area and points out the future work that needs to be done to elucidate the field of anabolic hormones after severe injury.