Growth hormone in the critically ill

Negative nitrogen balance is common in critically ill patients with prolonged intensive care unit stay. Growth hormone supplementation associated with adequate nutritional support in other patient groups resulted in preserved nitrogen balance. Despite the initial promising results of small trials, the large multicenter randomized controlled trial by Takala and colleagues showed that supranormal growth hormone supplementation in critically ill patients increased mortality and morbidity. Therefore, the use of growth hormone in intensive care unit in adult patients who are not known to be severely deficient is still considered inappropriate.