The effects of recombinant human growth hormone on cardiopulmonary function in elective abdominal aortic aneurysm repair

Objectives: cardiorespiratory complications are the predominant source of morbidity in patients undergoing major surgery. Recombinant human growth hormone (rhGH) has previously been shown to be effective in improving respiratory and cardiac function in compromised patients. Design: the aim of this study was to assess the effects of perioperative rhGH on cardiac function in 33 patients undergoing elective infrarenal abdominal aortic aneurysm repair. Methods: patients were randomised to one of three groups: placebo for 6 days before and after surgery (control, n = 12); genotropin (GH) 0.3 units/kg/day for 6 days before and after surgery (pre and postop GH, n = 10) and placebo for 6 days before and GH (0.3 units/kg/day) for 6 days after surgery (postop EH, n = 11). Patients were assessed on days 7 and 1 before and days 7, 14 and 50 after operation. Intraoperative cardiac index (CI) was measured after induction of anaesthesia, before and after aortic cross-clamping, after aortic unclamping and at the end of surgery. Results: pretreatment with GH resulted in a significantly higher heart rate during surgery and was associated with a trend towards higher cardiac index (CI) (p < 0.067) at all stages of surgery. Mean arterial blood pressure at the stage of aortic unclamping was significantly higher in patients treated with GH preoperatively. Conclusions: larger studies are required to evaluate the beneficial effects of GH in aortic surgery. However, data from this pilot study suggests that perioperative GH administration may result in improved cardiac performance during aortic surgery.