Use of Propranolol in Burn Centers

Abstract

Numerous burn centers use propranolol in both grownups and pediatric burn patients to weaken the hypermetabolic response associated to thermal injury despite the relative paucity of data in adults compared to children. The motive of this study was to distinguish practice patterns correlated to propranolol, for which groups it is being used, length of use, and the intended bene?t.

 A 17 question survey concerning the use of propranolol was dispersed to burn centers registered in the ABA website with a connection to deliver unidentified responses.

 A 31% response rate was attained. Results confirmed that 60.5% practice propranolol whereas 39.5% do not. The Usage of propanol in both mature and pediatric patients was stated in 82% of centers. The majority of centers (60.8%) initiate propranolol in patients with >20% TBSA burns. The drug is sustained while inpatient for most adults (43%) with only 10% continuing treatment up to 6 months vs. rates of 17.6% long term outpatient use in pediatric patients. Drug dosing reached from 10 to 40 mg in adults and 0.1 mg/kg to 5 mg/kg in pediatric patients dosed twice daily to four times daily with 25% and 40% titrating the dose to a reduced heart rate respectively. Propranolol was felt to advance outcomes in 56% of responses whereas 39% were ‘‘unsure’’.

The majority of centers practice propranolol for both adult and pediatric patients despise the deficiency of randomized studies in mature populations. An extensive difference of practice patterns highlights the need for additional study in respect to patient outcomes, period of therapy, and dosing to drive consensus guidelines.