Effect of propranolol administration in hemodynamic and metabolic responses of burned pediatric patients

David Herndon, R. E. Barrow, T. C. Rutan, P. Minifee, F. Jahoor, R. R. Wolfe

Research output: Contribution to journalArticle

114 Citations (Scopus)

Abstract

Hypermetabolism, increased heart rate, and lypolysis are responses to high catecholamine levels associated with burn injury. This study tests the hypothesis that adrenergic beta blockade in burns could reduce myocardial work, lipolysis, and negative nitrogen balance without adversely affecting cardiac or metabolic function. Eighteen patients with burns of 70 ± 3% total burn surface area (TBSA) (Mean ± SEM), were studied after a 5-day infusion of 2 mg/kg of intravenous (I.V.) propranolol infusion every 24 hours without their cardiac output or resting energy expenditure being adversely reduced. Heart rate, left ventricular work, and rate pressure product were significantly reduced by 20, 22, and 36%, respectively (P < 0.05). Plasma glucose, free fatty acids, triglycerides, and insulin levels remained unchanged. The rate of urea production, however, was significantly increased by 54 ± 12% in fasted patients, and to a much lesser 12 ± 2% in fed patients. The marked decrease in myocardial work afforded by propranolol administration may be of clinical benefit in the treatment of large burns. Variations in drug dosage and feeding regimens will, however, need to be perfected to limit catabolic effects.

Original languageEnglish (US)
Pages (from-to)484-492
Number of pages9
JournalAnnals of Surgery
Volume208
Issue number4
StatePublished - 1988

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Burns
Propranolol
Hemodynamics
Pediatrics
Heart Rate
Lipolysis
Nonesterified Fatty Acids
Intravenous Infusions
Cardiac Output
Adrenergic Agents
Energy Metabolism
Catecholamines
Urea
Triglycerides
Nitrogen
Insulin
Pressure
Glucose
Wounds and Injuries
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Surgery

Cite this

Herndon, D., Barrow, R. E., Rutan, T. C., Minifee, P., Jahoor, F., & Wolfe, R. R. (1988). Effect of propranolol administration in hemodynamic and metabolic responses of burned pediatric patients. Annals of Surgery, 208(4), 484-492.

Effect of propranolol administration in hemodynamic and metabolic responses of burned pediatric patients. / Herndon, David; Barrow, R. E.; Rutan, T. C.; Minifee, P.; Jahoor, F.; Wolfe, R. R.

In: Annals of Surgery, Vol. 208, No. 4, 1988, p. 484-492.

Research output: Contribution to journalArticle

Herndon, D, Barrow, RE, Rutan, TC, Minifee, P, Jahoor, F & Wolfe, RR 1988, 'Effect of propranolol administration in hemodynamic and metabolic responses of burned pediatric patients', Annals of Surgery, vol. 208, no. 4, pp. 484-492.
Herndon D, Barrow RE, Rutan TC, Minifee P, Jahoor F, Wolfe RR. Effect of propranolol administration in hemodynamic and metabolic responses of burned pediatric patients. Annals of Surgery. 1988;208(4):484-492.
Herndon, David ; Barrow, R. E. ; Rutan, T. C. ; Minifee, P. ; Jahoor, F. ; Wolfe, R. R. / Effect of propranolol administration in hemodynamic and metabolic responses of burned pediatric patients. In: Annals of Surgery. 1988 ; Vol. 208, No. 4. pp. 484-492.
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