The Safety and Efficacy of Propranolol in Reducing the Hypermetabolic Response in the Pediatric Burn Population

Journal of Burn Care & Research : Official Publication of the American Burn Association
Sylvia OjedaWalter Meyer

Abstract

Pediatric burn patients often have hypertension and tachycardia for several years post-injury. Propranolol has shown to be effective in treating the hypermetabolic state secondary to a major burn injury. This study was conducted to document a safe and effective dosing regimen for three different age groups. One hundred four burn-injured children with a 30% to 92% total body surface area burn were treated for 1 to 2 years with propranolol in the outpatient setting. Guardians of the patients were instructed on how to take and monitor the systolic blood pressure and heart rate, and document their vital signs several times a day. The documentation was reviewed with the guardian and patient, and based on age-specific vital sign parameters, propranolol dosing adjustment was done to measure at least 15% to 20% reduction in admission heart rate. Mean doses for the age groups were as follows: 0 to 3 years 5.2 ± 2.8 mg/kg/day, 4 to 10 years 4.2 ± 1.8 mg/kg/day, and 11 to 18 years 2.9 ± 1.4 mg/kg/day. The propranolol dose decreased as time post-burn increased. On selected patients, propranolol was stopped due to changes in the heart rate, but at all times, it was safe and effective. No adverse effects were noted. The dosing regimen was no...Continue Reading

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Citations

May 7, 2020·Current Opinion in Pediatrics·Kristin P PartainRajan K Thakkar
Feb 12, 2021·Burns : Journal of the International Society for Burn Injuries·Elizabeth BlearsAndrew J Murton
Apr 29, 2021·American Journal of Physiology. Cell Physiology·Carly M KnuthMarc G Jeschke

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