Volume 7 Supplement 2

23rd International Symposium on Intensive Care and Emergency Medicine

Open Access

Use of anabolic steroid therapy in critically ill ICU patients

  • J Pikul1 and
  • MD Sharpe2
Critical Care20037(Suppl 2):P014

https://doi.org/10.1186/cc1903

Published: 3 March 2003

Critical illness leads to a loss of lean body mass (LBM) and is associated with impaired immune function and wound healing, increased infection, and poorer outcomes [1, 2]. Aggressive nutritional support can decrease net catabolic losses by only ~50%, therefore other methods need to be examined. We initiated anabolic steroid therapy (AS) (nandrolone intramuscular injection, once weekly × three doses) on 10 critically ill patients. Criteria for AS: moderate to severe malnutrition, ICU stay > 14 days, tolerating enteral feeds, and exhibiting poor response to nutritional support. Feeds were 130–150% of measured energy expenditure and protein at 2.0–2.5 g/kg per day. Response was monitored by nitrogen balance and LBM.

Eight of 10 patients exhibited a good response to AS, with attainment of positive nitrogen balance and improvement in skeletal and visceral protein levels. AS may be useful as adjunctive therapy for malnourished, critically ill patients for protein repletion.

Table 1

 

2 weeks prior to AS

After 3 doses

Patient

Pre-ALB

N balance (g/day)

LBM (kg)

Pre-ALB

N balance (g/day)

LBM (kg)

1. F

0.09

+2.3

22.3

0.09

+3.2

22.8

2. F

0.08

-3.4

18.4

0.21

+4.8

19.2

3. M

0.11

-5.8

36.3

0.32

+7.2

38.1

4. M

< 0.07

-6.7

27.2

0.19

+1.8

27.9

5. M

0.18

-14.2

39.4

0.28

+6.9

40.8

6. F

0.07

-5.2

12.8

0.16*

+5.3*

15.3*

7. M

0.14

-6.8

N/A

0.35

+3.8

N/A

8. M

< 0.07

-10.2

29.1

0.16

+5.4

29.9

9. M

0.15

-17.6

20.5

0.14

-10.0

22.1

10. M

0.10

-19.6

26.8

0.14

+4.6

25.8

* Data collected 6 weeks post steroid.

Authors’ Affiliations

(1)
Department of Clinical Nutritional Services, University of Western Ontario
(2)
Department of Anesthesia, University of Western Ontario

References

  1. Chang DW, DeSanti L, Demling RH: Shock 1998, 10: 155-160.View ArticlePubMedGoogle Scholar
  2. Ferrando AA, Sheffield-Moore M, Wolf SE, et al.: Crit Care Med 2001, 29: 1936-1942. 10.1097/00003246-200110000-00015View ArticlePubMedGoogle Scholar

Copyright

© BioMed Central Ltd 2003

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