Human growth hormone kinetics in critically ill patients

M. Hiesmayr, Th Hölzenbein, L. Valentini, Th Sautner, J. Karner, E. Roth

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3 Citations (Scopus)

Abstract

Several studies have shown that exogenous human growth hormone (HGH) exerts an anabolic effect on protein metabolism in surgical patients with mild or moderate catabolism. However, contradictory results have been demonstrated in polytrauma patients where HGH did not improve protein metabolism. Aim of this study was to evaluate whether the pharmacokinetics of recombinant biosynthetic human GH (r-HGH) are altered in critically ill patients. After an overnight fast, r-HGH was infused at a rate of 460 μg/h/kg/bw during 120 min to five intensive care unit (ICU) patients. The patients were catabolic (nitrogen balance -11 ± 0.5), showed normal liver function, and only one patient had a slightly impaired kidney function (creatinine >1.5 mg/dl). Endogenous GH secretion was suppressed by continuous infusion of 50 μg/m 2/h somatostatin. From plasma GH curves, elimination half life (t1/2kle), whole body clearance (Cltot) and steady state distribution space (DS) were calculated in an open two compartment model. Additionally, the effects of r-HGH infusion on plasma insulin, glucagon and amino acid concentrations were evaluated. T1/2kle was 19.6 ± 2.3 min, Cltot 2.9 ± 0.4 ml/hg/bw/min and DS 76.4 ± 3.8 ml/kg/bw for 90 min. The plasma levels of total amino acids including the branched chain amino acids valine, leucine and isoleucine and of glutamine were significantly higher during r-HGH infusion than during the basal and somatostatin periods. In conclusion, the elimination of r-HGH in catabolic ICU patients is not different from that of healthy volunteers.

Original languageEnglish
Pages (from-to)352-357
Number of pages6
JournalWiener Klinische Wochenschrift
Volume108
Issue number12
Publication statusPublished - Jun 21 1996

Keywords

  • amino acids
  • branched-chain amino acids
  • glutamine
  • growth hormone
  • protein catabolism

ASJC Scopus subject areas

  • Medicine(all)

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    Hiesmayr, M., Hölzenbein, T., Valentini, L., Sautner, T., Karner, J., & Roth, E. (1996). Human growth hormone kinetics in critically ill patients. Wiener Klinische Wochenschrift, 108(12), 352-357.