| Oxandrolone does not improve outcome of ventilator dependent surgical patients. | |
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MedLine Citation:
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PMID: 15319718 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Multisystem injury and major surgical stress result in a hypermetabolic state with accelerated breakdown of protein stores. Loss of lean muscle mass impairs wound healing, increases infection rates, and weakens respiratory musculature. Oxandrolone is an anabolic steroid that attenuates loss of lean body mass and improves wound healing in burn patients. We hypothesized that oxandrolone would improve outcome for ventilator-dependent surgical patients. METHODS: We conducted a randomized, double-blind, placebo-controlled trial of oxandrolone therapy for surgical/trauma patients requiring >7 days of ventilation. The primary end point was time on the ventilator. RESULTS: Forty-one patients were enrolled between January 1, 2001, and June 15, 2003, 18 received oxandrolone (10 mg po BID) and 23 received a placebo. Groups were comparable for age, gender, injury severity score, and APACHE II score. The majority were trauma patients (83%), and 90% received enteral feeding. The oxandrolone group received higher caloric and protein intake before enrollment, but these differences were not significant. Contrary to our hypothesis, patients receiving oxandrolone spent significantly longer time on the ventilator than the placebo group (mean 21.7 days vs. 16.4 days, P = 0.03). There was no difference in infectious complications, acute respiratory distress syndrome, or multiple organ failure scores. Patients receiving oxandrolone had a longer intensive care unit stay but no difference in total hospital stay. CONCLUSION: Ventilator-dependent surgical patients receiving oxandrolone had a more prolonged course of mechanical ventilation, suggesting that oxandrolone may be detrimental in this circumstance. Oxandrolone may enhance collagen deposition and fibrosis in the later stages of acute respiratory distress syndrome and thus prolong recovery. |
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Authors:
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Eileen M Bulger; Gregory J Jurkovich; Catherine L Farver; Patricia Klotz; Ronald V Maier |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Annals of surgery Volume: 240 ISSN: 0003-4932 ISO Abbreviation: Ann. Surg. Publication Date: 2004 Sep |
Date Detail:
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Created Date: 2004-08-20 Completed Date: 2004-09-17 Revised Date: 2013-06-09 |
Medline Journal Info:
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Nlm Unique ID: 0372354 Medline TA: Ann Surg Country: United States |
Other Details:
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Languages: eng Pagination: 472-8; discussion 478-80 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, University of Washington, Seattle 98104, USA. ebulger@u.washington.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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APACHE Administration, Oral Anabolic Agents / administration & dosage*, adverse effects Cross Infection / diagnosis Dietary Proteins / administration & dosage Double-Blind Method Energy Intake Enteral Nutrition Female Humans Injury Severity Score Intensive Care Units Length of Stay Male Middle Aged Multiple Trauma / complications, therapy* Oxandrolone / administration & dosage*, adverse effects Prospective Studies Respiration, Artificial* |
| Grant Support | |
ID/Acronym/Agency:
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5P30 DK035816/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anabolic Agents; 0/Dietary Proteins; 53-39-4/Oxandrolone |
| Comments/Corrections | |
Comment In:
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Ann Surg. 2005 Jun;241(6):1030-1; author reply 1031-2
[PMID:
15912055
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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