Growth hormone administration during nutritional support: what is to be gained?

Studies over the past three decades have documented the protein-anabolic effects of human growth hormone (GH) administration in malnourished or critically ill patients. The availability of recombinant GH has facilitated clinical investigation on the metabolic and clinical effects of this peptide in ICU settings. These studies demonstrate that GH improves nutrient utilization efficiency in critically ill patients. Recent randomized, controlled trials document improved wound healing with GH therapy in both adult and pediatric burn patients and reduced length of hospital stay in pediatric burn injury. However, little data have been published on functional or clinical outcome variables in other groups of catabolic patients treated with GH. Administration of growth factors in combination with specialized nutrition represents a novel strategy that may improve outcomes in critically ill patients. Additional clinical studies are needed to further define the safety, functional benefits, cost-effectiveness, and clinical utility of GH use in catabolic patients.