Growth Hormone in Critical Care Practice

  • J. Wernerman
  • H. Barle
  • P. Essén
Conference paper


The altered protein metabolism of critically ill patients is an adjustment to the specific needs of the body in a situation of strenuous demands. In short aminoacid substrates are mobilized from skeletal muscle and transported by the bloodflow to visceral organs of priority in the splanchnic area. Glutamine is a key substance as an energy substrate for enterocytes and immunocompetent cells, which can rapidly be utilized as a precursor for nucleotid synthesis when needed [1]. In critical illness the export of glutamine from skeletal muscle is increased threefold or more [2]. It is not clear how long a muscle is capable to maintain this elevated glutamine production. However, it is obvious that a pronounced protein depletion occurs in muscles of patients that develop multiple organ failure and consequently become long-stayers in the ICU [3]. Muscle proteins are degraded in order to obtain aminoacid substrates for the production of glutamine. The muscle depletion that ensues has two major consequences: a decreasing ability to produce aminoacid substrates and a functional impairment. When the amounts of muscle proteins available for degradation diminishes, the production of glutamine can no longer be kept at a level to meet the demands of the proliferating tissues. A shortage of glutamine develops in tissues dependent upon a rich supply, such as the intestinal mucosa and the immunocompetent cells.


Growth Hormone Muscle Protein Synthesis Recombinant Human Growth Hormone Glutamine Supplementation Spec Suppl 
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Copyright information

© Springer-Verlag Italia 1997

Authors and Affiliations

  • J. Wernerman
  • H. Barle
  • P. Essén

There are no affiliations available

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