Beta-blockade in burns

C. T. Pereira, M. G. Jeschke, David Herndon

Research output: Chapter in Book/Report/Conference proceedingConference contribution

27 Citations (Scopus)

Abstract

A significant proportion of the mortality and morbidity of severe burns is attributable to the ensuing hypermetabolic response that typically lasts for at least 9-12 months post-injury. This is associated with impaired wound healing, increased infection risks, erosion of lean body mass, hampered rehabilitation and delayed reintegration of burn survivors into society. The endocrine status is markedly altered during this period with an initial and then sustained increase in proinflammatory 'stress' hormones such as cortisol and other glucocorticoids, and catecholamines including epinephrine and norepinephrine by the adrenal medulla and cortex. These hormones exert catabolic effects leading to muscle wasting, the intensity of which depends upon the percentage of total body surface area (TBSA) involved, as well as the time elapsed since initial injury. Pharmacological and non-pharmacological strategies may be used to reverse the catabolic effect of thermal injury. Of these, β-adrenergic blockade with propranolol has been the most efficacious anti-catabolic therapy in the treatment of burns. The underlying mechanism of action of propranolol is still unclear, however its effect appears to occur due to an increased protein synthesis in the face of a persistent protein breakdown and reduced peripheral lipolysis. This article aims to review the current understanding of catecholamines in postburn muscle wasting and focuses on the clinical and metabolic effects of β-blockade in severe burns.

Original languageEnglish (US)
Title of host publicationNovartis Foundation Symposium
Pages238-248
Number of pages11
Volume280
StatePublished - 2007
Externally publishedYes

Publication series

NameNovartis Foundation Symposium
Volume280
ISSN (Print)15282511

Fingerprint

Burns
Propranolol
Catecholamines
Wounds and Injuries
Hormones
Muscles
Adrenal Medulla
Lipolysis
Body Surface Area
Adrenal Cortex
Adrenergic Agents
Wound Healing
Glucocorticoids
Epinephrine
Survivors
Hydrocortisone
Norepinephrine
Proteins
Rehabilitation
Hot Temperature

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pereira, C. T., Jeschke, M. G., & Herndon, D. (2007). Beta-blockade in burns. In Novartis Foundation Symposium (Vol. 280, pp. 238-248). (Novartis Foundation Symposium; Vol. 280).

Beta-blockade in burns. / Pereira, C. T.; Jeschke, M. G.; Herndon, David.

Novartis Foundation Symposium. Vol. 280 2007. p. 238-248 (Novartis Foundation Symposium; Vol. 280).

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Pereira, CT, Jeschke, MG & Herndon, D 2007, Beta-blockade in burns. in Novartis Foundation Symposium. vol. 280, Novartis Foundation Symposium, vol. 280, pp. 238-248.
Pereira CT, Jeschke MG, Herndon D. Beta-blockade in burns. In Novartis Foundation Symposium. Vol. 280. 2007. p. 238-248. (Novartis Foundation Symposium).
Pereira, C. T. ; Jeschke, M. G. ; Herndon, David. / Beta-blockade in burns. Novartis Foundation Symposium. Vol. 280 2007. pp. 238-248 (Novartis Foundation Symposium).
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