Severe burns over a large portion of a child’s body can speed up normal metabolic processes to alarming levels. This “hypermetabolic” response causes dangerous acceleration in a child’s heart rate and cardiac output, as well as other physiological problems that, unless checked, can interfere with the body’s ability to use oxygen, glucose and other essential factors. Over time, young patients may experience losses in lean body mass, bone mineral content and density, and nutritional problems that interfere with growth.
Oxandrolone, a steroid drug, has been used to help young burn patients. In the short term, the drug helped young burn patients maintain body mass and shortened their stay in the intensive care unit. However, there were no data available to assess the long-term effects of the drug.
With support from the Pediatric Trauma and Critical Illness Branch, researchers conducted a randomized controlled trial of oxandrolone and followed the patients for 5 years to assess long-term outcomes. Young burn patients were randomly divided into two groups: One group received oxandrolone for 1 year post-burn, and the other group received a placebo. Within each group, some children were randomly chosen to receive an additional exercise program. The patients were followed for 5 years after the burn.
The researchers found that severely burned children who received oxandrolone had a stronger long-term recovery in height, bone mineral content, and muscle strength, compared with children who received the placebo. The children who received both the oxandrolone and the additional exercise program gained even more in muscle strength. These benefits persisted for the full 5 years post burn, without adverse side effects (PMID: 22463890).