Resting β-Adrenergic Blockade Does Not Alter Exercise Thermoregulation in Children With Burn Injury: A Randomized Control Trial

Eric Rivas, Serina J. McEntire, David Herndon, Oscar Suman

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

The objective of this study was to test the hypothesis that propranolol, a commonly prescribed β-blocker to burned children, in combination with exercise-heat stress, increases the risk of heat illness and exercise intolerance. In a randomized double-blind study, propranolol was given to 10 burned children, and placebo was given to 10 additional burned children (matched for TBSA burned; mean ± SD, 62 ± 13%), while nonburned children served as healthy controls. All groups were matched for age and body morphology (11.2 ± 3.0 years; 146 ± 19 cm; 45 ± 18 kg; 1.3 ± 0.4 m). All children exercised in hot conditions (34.3 ± 1.0°C; 26 ± 2% relative humidity) at 75% of their peak aerobic capacity. At the end of exercise, none of the groups differed for final or change from baseline intestinal temperature (38.0 ± 0.5°C; 0.021 ± 0.01Δ°C·min), unburned (37.0 ± 0.6°C) and burned skin temperatures (36.9 ± 0.7°C; nonburn group excluded), heat loss (20.5 ± 18 W m), whole-body thermal conductance (118 ± 113 W m), or physiological strain index (5.6 ± 1). However, burn children exercised less than nonburn group (21.2 ± 8.6 vs 30 ± 0.0 min; P < .001) and had a lower calculated exercise tolerance index (6.7 ± 4.3 vs 1.0 ± 0.0; P < .01). Burned children had lower peak heart rates than nonburned children (173 ± 13 vs 189 ± 7 bpm; P < .01), with greater relative cardiac work rates at the end of exercise (97 ± 10 vs 85 ± 11% peak heart rate; P < .01). Resting β-adrenergic blockade does not affect internal body temperature of burned children exercising at similar relative intensities as nonburn children in the heat. Independent of propranolol, a suppressed cardiac function may be associated to exercise intolerance in children with severe burn injury.

Original languageEnglish (US)
JournalJournal of Burn Care and Research
DOIs
StateAccepted/In press - Jun 28 2017

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Body Temperature Regulation
Adrenergic Agents
Exercise
Wounds and Injuries
Hot Temperature
Propranolol
Heart Rate
Exercise Tolerance
Skin Temperature
Humidity
Body Temperature
Double-Blind Method
Research Design
Placebos

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Rehabilitation

Cite this

Resting β-Adrenergic Blockade Does Not Alter Exercise Thermoregulation in Children With Burn Injury : A Randomized Control Trial. / Rivas, Eric; McEntire, Serina J.; Herndon, David; Suman, Oscar.

In: Journal of Burn Care and Research, 28.06.2017.

Research output: Contribution to journalArticle

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abstract = "The objective of this study was to test the hypothesis that propranolol, a commonly prescribed β-blocker to burned children, in combination with exercise-heat stress, increases the risk of heat illness and exercise intolerance. In a randomized double-blind study, propranolol was given to 10 burned children, and placebo was given to 10 additional burned children (matched for TBSA burned; mean ± SD, 62 ± 13{\%}), while nonburned children served as healthy controls. All groups were matched for age and body morphology (11.2 ± 3.0 years; 146 ± 19 cm; 45 ± 18 kg; 1.3 ± 0.4 m). All children exercised in hot conditions (34.3 ± 1.0°C; 26 ± 2{\%} relative humidity) at 75{\%} of their peak aerobic capacity. At the end of exercise, none of the groups differed for final or change from baseline intestinal temperature (38.0 ± 0.5°C; 0.021 ± 0.01Δ°C·min), unburned (37.0 ± 0.6°C) and burned skin temperatures (36.9 ± 0.7°C; nonburn group excluded), heat loss (20.5 ± 18 W m), whole-body thermal conductance (118 ± 113 W m), or physiological strain index (5.6 ± 1). However, burn children exercised less than nonburn group (21.2 ± 8.6 vs 30 ± 0.0 min; P < .001) and had a lower calculated exercise tolerance index (6.7 ± 4.3 vs 1.0 ± 0.0; P < .01). Burned children had lower peak heart rates than nonburned children (173 ± 13 vs 189 ± 7 bpm; P < .01), with greater relative cardiac work rates at the end of exercise (97 ± 10 vs 85 ± 11{\%} peak heart rate; P < .01). Resting β-adrenergic blockade does not affect internal body temperature of burned children exercising at similar relative intensities as nonburn children in the heat. Independent of propranolol, a suppressed cardiac function may be associated to exercise intolerance in children with severe burn injury.",
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