β-blockade and growth hormone after burn

Objective: To determine whether propranolol and growth hormone (GH) have additive effects to combat burn-induced catabolism. Summary Background Data: Both GH and propranolol have been attributed anabolic properties after severe trauma and burn. It is conceivable that the two in combination would have additive effects. Methods: Fifty-six children with more than 40% TBSA burns were randomized to one of four anabolic regimens: untreated control, GH treatment, propranolol treatment, or combination GH plus propranolol therapy. Clinical treatment was identical for all groups. Resting energy expenditure was determined by indirect calorimetry and skeletal muscle protein kinetics were measured using stable amino acid isotope infusions before and after each anabolic regimen. Results: There were no differences in age, sex, or burn size between groups. Tachycardia and energy expenditure were decreased during propranolol treatment (P < .05). The net balance of muscle protein synthesis and breakdown was improved during proprandol and GH plus propranolol treatment (P < .05). There was no significant benefit of GH alone. No additive effect of combination therapy was seen. Conclusions: Propranolol is a strongly anabolic drug during the early, hypercatabolic period after burn. No synergistic effect between propranolol and GH was identified.