Steroids for burn trauma
- Thread starter bochinit
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tareload
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Comes with own set of trade-offs, but here's a good place to start:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699141/
Without doubt, calorie and protein delivery is mandatory to allow for recovery, both clinically and functionally, but it alone will not optimize our patients' chances to hold their children again. As I have stated in past discussions [35], we as humans are not evolved to survive major critical or surgical illness. Mother Nature never intended us to survive major trauma from the saber-tooth tiger attack on the caveman, and similarly we are not evolved to survive major trauma, sepsis, or surgical interventions. Although we may save many patients using modern technology and get them out of the ICU, our lean body mass reserve and overall metabolic reserve are not sufficient in many cases to allow for a meaningful QOL again. As previously discussed, hypermetabolism and catabolism can persist for months to years after illness/injury [13,14] and this will require not only optimal nutrition, but perhaps pharmacologic intervention to overcome.
Further, anabolic agents such as oxandrolone have shown to be efficacious in reducing the length of stay, shortening time to wound healing, and improving survival in major burns [36]. These agents unquestionably improve lean body mass and function in both patients and athletes. However, the question remaining unanswered is when to initiate them? Ideally, these agents (oxandrolone, Growth Hormone, etc.) would be initiated following the transition from the "acute phase" to the recovery phase [35] (see Figure Figure5).5). An objective measurement predicting this transition has yet to be described; we would like to hypothesize that a measure of muscle health, like the muscle glycogen test described previously, could one day be a measure to signal this transition. We noted that a number of patients showed recovery of their muscle glycogen (with scores increasing from 0 to >15) over the first week of ICU stay. When muscle glycogen scores begin to increase, we hypothesize patients may be able to sustain anabolism and be responsive to an anabolic agent like oxandrolone (Figure (Figure55).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699141/
Without doubt, calorie and protein delivery is mandatory to allow for recovery, both clinically and functionally, but it alone will not optimize our patients' chances to hold their children again. As I have stated in past discussions [35], we as humans are not evolved to survive major critical or surgical illness. Mother Nature never intended us to survive major trauma from the saber-tooth tiger attack on the caveman, and similarly we are not evolved to survive major trauma, sepsis, or surgical interventions. Although we may save many patients using modern technology and get them out of the ICU, our lean body mass reserve and overall metabolic reserve are not sufficient in many cases to allow for a meaningful QOL again. As previously discussed, hypermetabolism and catabolism can persist for months to years after illness/injury [13,14] and this will require not only optimal nutrition, but perhaps pharmacologic intervention to overcome.
Further, anabolic agents such as oxandrolone have shown to be efficacious in reducing the length of stay, shortening time to wound healing, and improving survival in major burns [36]. These agents unquestionably improve lean body mass and function in both patients and athletes. However, the question remaining unanswered is when to initiate them? Ideally, these agents (oxandrolone, Growth Hormone, etc.) would be initiated following the transition from the "acute phase" to the recovery phase [35] (see Figure Figure5).5). An objective measurement predicting this transition has yet to be described; we would like to hypothesize that a measure of muscle health, like the muscle glycogen test described previously, could one day be a measure to signal this transition. We noted that a number of patients showed recovery of their muscle glycogen (with scores increasing from 0 to >15) over the first week of ICU stay. When muscle glycogen scores begin to increase, we hypothesize patients may be able to sustain anabolism and be responsive to an anabolic agent like oxandrolone (Figure (Figure55).
madman
Super Moderator
oxandrolone is commonly prescribed as well as nandrolone due to it being one of the best muscle tissue building anabolic steroids.
bochinit
Active Member
Thanks guys for the reply,
Oxandrolone can be supported for long term-usage? This steroids is know, as the other oral steroids, to have impact on lipids, right?
Seems to be a good medicament for some clinic uses, and have access to it. I will research more info of how manage side effects and if someone have experience with it, please contact me.
Oxandrolone can be supported for long term-usage? This steroids is know, as the other oral steroids, to have impact on lipids, right?
Seems to be a good medicament for some clinic uses, and have access to it. I will research more info of how manage side effects and if someone have experience with it, please contact me.
madman
Super Moderator
Oxandrolone in the treatment of burn injuries: A systematic review and meta-analysis
Abstract Background: Severe burns induce a profound hypermetabolic response, leading to a prolonged state of catabolism associated with organ dysfunction and delay of wound healing. Oxandrolone, a synthetic testosterone analog, may alleviate the hypermetabolic catabolic state thereby decreasing associated morbidity. However, current literature has reported mixed outcomes on complications following Oxandrolone use, specifically liver and lung function. We conducted an updated systematic review and meta-analysis studying the effects of Oxandrolone on mortality, length of hospital stay, progressive liver dysfunction, and nine secondary outcomes.
Methods: We searched Pubmed, EMBASE, Web of Science, CINAHL, and Cochrane Databases of Systematic Reviews and Randomized Controlled Trials. 31 Randomized control trials and observational studies were included. Basic science and animal studies were excluded. Only studies comparing Oxandrolone to standard of care, or placebo, were included.
Results: Oxandrolone did not affect rates of mortality (RR:0.72; 95% CI(0.47-1.08);p=0.11) or progressive liver dysfunction (RR:1.04; 95% CI(0.59-1.85);p=0.88), but did decrease length of stay in-hospital. Oxandrolone significantly increased weight re-gain, bone mineral density, percent lean body mass, and decreased wound healing time for donor graft sites. Oxandrolone did not change the incidence of transient liver dysfunction or mechanical ventilation requirements.
Conclusions: There is evidence to suggest that Oxandrolone is a beneficial adjunct to the acute care of burn patients; shortening hospital stays and improving several growth and wound healing parameters. It does not appear that Oxandrolone increases the risk of progressive or transient liver injury, although monitoring liver enzymes is recommended.
Conclusions
There is evidence to suggest that the addition of Oxandrolone to standard treatment for burn patients decreases length of stay in hospital by accelerating wound healing, but does not appear to affect mortality rates. Although the definition of liver dysfunction was not consistent among the studies included, and we recommend continued monitoring of liver enzymes levels in patients receiving Oxandrolone, we did not find evidence of increased risk of transient or progressive liver dysfunction. Following burn injury, Oxandrolone appears to significantly increase weight gain, accelerate wound healing for skin graft donor sites, and improve body composition. We found that children did not experience increased morbidity or mortality when compared adults given Oxandrolone, and may additionally benefit from improved bone mineral density. Therefore, we suggest that Oxandrolone is a safe adjunct in the treatment of severely burned patients.
Nelson Vergel
Founder, ExcelMale.com
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