the effect of ketoconazole on post-burn inflammation, hypermetabolism and clinical outcomes酮康唑的影响在烧伤后炎症、代谢亢进和临床结果.pdfVIP

The Effect of Ketoconazole on Post-Burn Inflammation, Hypermetabolism and Clinical Outcomes Marc G. Jeschke1,2,5., Felicia N. Williams1,2., Celeste C. Finnerty1,2,3., Noe A. Rodriguez1,2, 1,2 4 1,2 1,2 1,2 Gabriela A. Kulp , Arny Ferrando , William B. Norbury , Oscar E. Suman , Robert Kraft , Ludwik K. Branski1,2, Ahmed M. Al-mousawi1,2, David N. Herndon1,2* 1 Shriners Hospitals for Children, University of Texas Medical Branch, Galveston, Texas, United States of America, 2 Department of Surgery, University of Texas Medical Branch, Galveston, Texas, United States of America, 3 Institute for Translational Sciences and the Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America, 4 University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America, 5 Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada Abstract Background: Hypercortisolemia has been suggested as a primary hormonal mediator of whole-body catabolism following severe burn injury. Ketoconazole, an anti-fungal agent, inhibits cortisol synthesis. We, therefore, studied the effect of ketoconazole on post-burn cortisol levels and the hyper-catabolic response in a prospective randomized trial (block randomization 2:1). Methodology/Principal Findings: Fifty-five severely burned pediatric patients with .30% total body surface area (TBSA) burns were enrolled in this trial. Patients were randomized to receive standard care plus either placebo (controls, n = 38) or ketoconazole (n = 23). Demographics, clinical data, serum hormone levels, serum cytokine expression p