Effects of Nandrolone on Outcomes and Metabolic Response in Critically Ill Patients

Two major difficulties in critical care are muscle weakness and malnutrition. Their prevalence in critically ill patients is about 30-50% during hospital stays, and they can also affect routine patient life after discharge, even leading to recurrent infection and death. Metabolic responses to injury have specific effects on metabolic phases in patients.

This study is a randomized, double-blind, clinical trial on critically ill patients in two groups. Both groups were checked for metabolic markers and demographic characteristics during admission and before discharge. In the nandrolone group, 25mg of nandrolone (IM) was injected weekly for three weeks. In the control group, normal saline was used as a placebo. To assess metabolic responses, albumin, total protein, and testosterone levels were checked, in addition to static measures such as cross-sections of rectus femur and mid-upper arm circumference.

There were no significant differences in SOFA and APACHE 2 scores, PSA, ESR, CRP, and PTC levels between the two groups (p<0.05). Results also showed no significant differences between the mean of length of hospital stay, serum albumin, total protein, hemoglobin, testosterone, and HDL between the two groups (p<0.05). LDL and TG had P-values of 0.01 and 0.012, respectively. MUAC and sonographic findings of rectus femoris muscle were better in the case group (P-values 0.008 and 0.012).

Nandrolone had no significant effects on metabolic markers in critically ill patients, except for TG and LDL. The changes in muscle characteristics were significant. However, more study is needed to assess muscular power.