Catabolic effect of dexamethasone in patients with major head injuries

In the records of our extensive metabolic studies on trauma victims, we found 16 head injured patients who had no other major injuries. Among them, nine had been given dexamethasone for at least 6 days. The other seven had not received any corticosteroids. There was no significant difference in the Glasgow Coma Scales of the treated and untreated groups. Metabolic balance studies were carried out for at least 3 days, including the periods when the treated patients were receiving dexamethasone. Mean nitrogen balance was -0.296 +/- 0.03 g/kg/day for the treated group and -0.182 +/- 0.03 g/kg/day for the untreated group. This difference was significant (p = 0.02, t-test). Our metabolic data are also consistent with those of other published studies, which used other corticosteroids and somewhat different methodologies. Thus, it is clearly established that corticosteroids cause significant degrees of catabolism in head injured patients, beyond what would "normally" be expected in such patients if they did not receive these drugs.