Long-Term Administration of Oxandrolone Improves Lung Function in Pediatric Burned Patients

Abstract

Pulmonary dysfunction is a significant contributor to morbidity and mortality in the pediatric burned population. We have previously reported that the administration of a synthetic testosterone derivative, oxandrolone, significantly reduced hypermetabolism, and significantly increased height percentile, bone mineral content, lean body mass, and strength in pediatric burned patients. We hypothesize that the administration of oxandrolone will improve pulmonary function in burned pediatric subjects. A subset of severely burned pediatric subjects from a prospective clinical trial (n = 222) were included in our study (n = 54, 7-18 years, ≥30% TBSA burn). The subjects were previously randomized to either the control arm (n = 35) or the oxandrolone arm (0.1 mg/kg twice/day for 12 months, n = 19). Maximum voluntary ventilation, the ratio between forced expiratory volume and forced vital capacity, and diffusion capacity were measured 6 months following burn injury, and results were compared between burned subjects with and without oxandrolone administration. Maximum expired ventilation (VEmax) was also measured in a subset of burned subjects. Subjects treated with oxandrolone had a significantly higher maximum voluntary ventilation (98 ± 53 L/min vs 115 ± 56 with treatment, P = .03). During maximal exercise, subjects treated with oxandrolone had a significantly higher VEmax compared with untreated subjects (32.0 ± 8.7 L/min vs 43.7 ± 13.6 with treatment, P = .02). The administration of oxandrolone was associated with improved lung function in pediatric burned patients.

Trial registration: ClinicalTrials.gov NCT00675714.

Figure 1

The consort diagram depicts patient allocation into this study. Subjects were included in our analyses if he/she had ≥30% TBSA burned, were between the ages of 7-18 years, and completed a pulmonary function test at the six-month time point.

Figure 2

Oxandrolone significantly improves maximum voluntary ventilation (MVV). The means with confidence intervals of MVV between burned subjects with and without oxandrolone treatment are shown in Figure 2. (*) represents significance of p<0.05 compared to control.

Figure 3

Exercise maximal minute ventilation (VE_Max) significantly increases with oxandrolone. Means with standard deviations of VE_Max between burned subjects with and without oxandrolone treatment are shown in Figure 3. (*) represents significance of p<0.05 compared to control.