Objectives: The aim of this study was to determine the appropriate propranolol dosing strategy for reducing heart rate in severely burned adults. Methods: A total of 26 patients (≥18 years) with burns covering ≥30% of the total body surface area were included in this IRB-approved study. Plasma propranolol concentrations were determined in a placebo group (n = 10) or following one of three dosing strategies: Q6 (n = 4), Q8 (n = 6), and Q24 (n = 6). Blood was collected just before dosing and at regular intervals over two dosing periods with corresponding heart rate and blood pressure recordings. Statistical significance was determined by one-way ANOVA followed by the appropriate post-hoc test. Results: Heart rate was 86. ±. 2 bpm for Q6, 93. ±. 3 bpm for Q8, and 90. ±. 4 bpm for Q24. The Q8 group had a significantly higher heart rate than the Q6 group (p = 0.0001). Plasma propranolol concentrations were significantly higher in the Q6 dosing strategy than in the Q8 dosing strategy (p = 0.02). Conclusions: Heart rate can be decreased to a similar degree with Q6 and Q24 dosing strategies, with the Q8 dosing strategy being less effective. Q6 dosing is recommended to maintain reduced heart rate throughout dosing periods.
- Heart rate
- β-Adrenergic receptor antagonists
ASJC Scopus subject areas
- Emergency Medicine
- Critical Care and Intensive Care Medicine