Use of anticatabolic agents for burns

Severe burn injury leads to a catabolic state caused by inflammatory mediators and increased levels of catabolic hormones. The result is a marked loss of body protein stores leading to immune deficiency, impaired healing, muscle weakness, and loss of organ function. Optimum nutrition-especially a high protein intake (2 g/kg/d)–can attenuate but not prevent a significant loss of lean body mass. The addition of anabolic agents to optimum burn care and nutrition, can further decrease nitrogen losses and increase the rate of restoration of muscle mass and protein stores during the recovery period. These anabolic agents include glutamine, in doses of 0.5 g/kg/d, human growth hormone, or the oral testosterone analogue oxandrolone. Levels of all three compounds are decreased after severe injury. Oxandrolone appears to be of particular benefit because of its high anabolic potency and minimal side effects. Resistance exercises are also an important anabolic stimulus to initiate early in the post-burn period.