Effect of recombinant growth hormone on immune response in pediatric burn patients

Abstract

Background Management of severely burnt children is one of the most challenging situations in the ICU. Control of the hypercatabolic state is the most limiting step that determines patient survival. Immunocompromisation and delayed wound healing usually result in severe sepsis, which is the most common direct cause of death in these patients. There is debate about the efficacy and safety of recombinant human growth hormone (rGH), although it has been used to improve healing of burnt patients. Role of growth hormone in immunomodulation has been proposed theoretically and serologically, but it has not been tested clinically. We reported in this study how far the use of rGH in the management of burnt patients can improve their immune status and increase survival. Patients and methods Forty pediatric patients were enrolled in this study, randomly assigned into two groups. Group A received rGH and was compared with group B, which did not receive rGH. Those two groups were compared with respect to overall mortality rate, hospital and ICU stay, serum transferrin, C-reactive protein, and positivity of blood culture. Results The overall mortality rate was slightly lower in group A (20%) compared with B group (25%). No significant decrease in hospital stay was noticed between the two groups. There was significant improvement in serum transferrin especially by day 14 in addition to a significant drop in C-reactive protein in group A. Group A was found to be more protected from bacteremia. Conclusion The use of rGH in pediatric burnt patients improves overall mortality and optimizes immune status, in addition to improvement of wound healing and donor site healing. This eventually reduces the length of hospital stay.