TY - JOUR
T1 - Long-term propranolol use in severely burned pediatric patients
T2 - A randomized controlled study
AU - Herndon, David N.
AU - Rodriguez, Noe A.
AU - Diaz, Eva C.
AU - Hegde, Sachin
AU - Jennings, Kristofer
AU - Mlcak, Ronald P.
AU - Suri, Jaipreet S.
AU - Lee, Jong O.
AU - Williams, Felicia N.
AU - Meyer, Walter
AU - Suman, Oscar E.
AU - Barrow, Robert E.
AU - Jeschke, Marc G.
AU - Finnerty, Celeste C.
PY - 2012/9
Y1 - 2012/9
N2 - Objective: To determine the safety and efficacy of propranolol given for 1 year on cardiac function, resting energy expenditure, and body composition in a prospective, randomized, single-center, controlled study in pediatric patients with large burns. Background: Severe burns trigger a hypermetabolic response that persists for up to 2 years postburn. Propranolol given for 1 month postburn blunts this response. Whether propranolol administration for 1 year after injury provides a continued benefit is currently unclear. Methods: One-hundred seventy-nine pediatric patients with more than 30% total body surface area burns were randomized to control (n = 89) or 4 mg/kg/d propranolol (n = 90) for 12 months postburn. Changes in resting energy expenditure, cardiac function, and body composition were measured acutely at 3, 6, 9, and 12 months postburn. Statistical analyses included techniques that adjusted for non-normality, repeated-measures, and regression analyses. P < 0.05 was considered significant. Results: Long-term propranolol treatment significantly reduced the percentage of the predicted heart rate and percentage of the predicted resting energy expenditure, decreased accumulation of central mass and central fat, prevented bone loss, and improved lean body mass accretion. There were very few adverse effects from the dose of propranolol used. Conclusions: Propranolol treatment for 12 months after thermal injury, ameliorates the hyperdynamic, hypermetabolic, hypercatabolic, and osteopenic responses in pediatric patients.
AB - Objective: To determine the safety and efficacy of propranolol given for 1 year on cardiac function, resting energy expenditure, and body composition in a prospective, randomized, single-center, controlled study in pediatric patients with large burns. Background: Severe burns trigger a hypermetabolic response that persists for up to 2 years postburn. Propranolol given for 1 month postburn blunts this response. Whether propranolol administration for 1 year after injury provides a continued benefit is currently unclear. Methods: One-hundred seventy-nine pediatric patients with more than 30% total body surface area burns were randomized to control (n = 89) or 4 mg/kg/d propranolol (n = 90) for 12 months postburn. Changes in resting energy expenditure, cardiac function, and body composition were measured acutely at 3, 6, 9, and 12 months postburn. Statistical analyses included techniques that adjusted for non-normality, repeated-measures, and regression analyses. P < 0.05 was considered significant. Results: Long-term propranolol treatment significantly reduced the percentage of the predicted heart rate and percentage of the predicted resting energy expenditure, decreased accumulation of central mass and central fat, prevented bone loss, and improved lean body mass accretion. There were very few adverse effects from the dose of propranolol used. Conclusions: Propranolol treatment for 12 months after thermal injury, ameliorates the hyperdynamic, hypermetabolic, hypercatabolic, and osteopenic responses in pediatric patients.
KW - beta blockade
KW - hypermetabolism
KW - lean body mass
KW - propranolol
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U2 - 10.1097/SLA.0b013e318265427e
DO - 10.1097/SLA.0b013e318265427e
M3 - Article
C2 - 22895351
AN - SCOPUS:84865474768
SN - 0003-4932
VL - 256
SP - 402
EP - 411
JO - Annals of surgery
JF - Annals of surgery
IS - 3
ER -