ASSESSMENT OF ANABOLIC AGENTS AND EXERCISE IN BURNED CHILDREN

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。背景：严重烧伤的儿童在烧伤后长达一年的时间里，其愈合体的能量需求增加。在这种高代谢状态下，它们会浪费脂肪和肌肉组织，停止生成新的骨骼。这可能会妨碍儿童时期的正常成长，使他们处于虚弱的状态，并妨碍他们得到适当的康复和重新融入社会。假设：使用有组织的运动训练计划和使用合成代谢药物将减少烧伤后的高代谢状态，加快康复。具体目的和程序（摘要）：1)烧伤儿童在烧伤后的第一年持续处于高代谢状态，导致肌肉萎缩、虚弱、骨质流失、生长下降、抗感染能力下降和疤痕增加。2)我们假设，通过不同的基本机制，这些分解代谢-高代谢反应可以通过治疗性使用：锻炼计划、奥雄龙、心得安、酮康唑来改善。实验设计（总结）：患者将在第一次手术后5天开始进行不同组的运动和药物治疗。患者将在特定的时间间隔接受各种测试和测量（烧伤后出院、6、9、12、18、24个月）。在研究结束时，将对各组进行比较。意义（摘要）：本研究将对改善严重烧伤后的治疗具有重要意义。它将提供可能导致改进临床护理方法的信息，从而改善和加速康复过程。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Background: Children with major burn injuries have increased energy needs for their healing bodies for up to one year post burn. During this hypermetabolic state they waste fat and muscle tissue and stop producing new bone. This can diminish their normal growth of childhood, leave them in a weakened state and prevent them from proper rehabilitation and reintegration back into society. Hypothesis: The use of a structured exercise training program and the use of anabolic drugs will decrease the hypermetabolic state following burn injury and quicken rehabilitation. Specific Aims and Procedures (summary): 1) A hypermetabolic state continues in burned children through the first year post burn causing muscle wasting, weakness, bone loss, decreased growth, decreased ability to fight infection, and increased scarring. 2) We hypothesize that by separate basic mechanisms, these catabolic-hypermetabolic responses may be ameliorated by therapeutic use of: An exercise program, Oxandrolone, Propranolol, Ketoconazole. Experimental Design (summary): Patients will be various groups of exercise and drugs beginning at 5 days after the first operation. Patients will be assessed at specific time intervals with a variety of tests and measurements (discharge, 6, 9, 12, 18, 24 months post burn). At the end of the study the groups will be compared to each other. Significance (summary): This study will have significant implications to improve treatment following a severe burn injury. It will provide information that may lead to improved methods of clinical care that will improve and hasten the recovery process.