Related Experiment Videos
Long-term propranolol use in severely burned pediatric patients: a randomized controlled study
David N Herndon1, Noe A Rodriguez, Eva C Diaz
1Shriners Hospitals for Children-Galveston, Galveston, TX 77550, USA. dherndon@utmb.edu
Annals of Surgery
|August 17, 2012
Summary
One year of propranolol treatment in pediatric burn patients improved cardiac function and body composition while reducing resting energy expenditure. This long-term propranolol administration demonstrated safety and efficacy in managing post-burn hypermetabolism.
Area of Science:
- Pediatric burn recovery
- Pharmacological interventions for burns
- Metabolic response to injury
Background:
- Severe burns induce a prolonged hypermetabolic state post-injury.
- Short-term propranolol (1 month) can mitigate this hypermetabolic response.
- The long-term benefits of 1-year propranolol administration remain under investigation.
Purpose of the Study:
- To assess the safety and efficacy of 1-year propranolol treatment in pediatric burn patients.
- To evaluate the impact on cardiac function, resting energy expenditure, and body composition.
- To determine sustained benefits beyond initial burn recovery.
Main Methods:
- Prospective, randomized, single-center, controlled study.
- 179 pediatric patients with >30% total body surface area burns were randomized.
- Propranolol (4 mg/kg/d) or placebo administered for 12 months postburn, with regular assessments.
Main Results:
- Long-term propranolol significantly reduced heart rate and resting energy expenditure.
- Improved lean body mass accretion and decreased central fat accumulation.
- Prevented bone loss with minimal adverse effects observed.
Conclusions:
- 12-month propranolol treatment effectively ameliorates hyperdynamic, hypermetabolic, hypercatabolic, and osteopenic responses in pediatric burn patients.
- Demonstrates a favorable safety profile for long-term use.
- Study registered at clinicaltrials.gov: NCT00675714.
Related Concept Videos
01:27Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in bronchial smooth...
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
01:31Adrenergic Antagonists: ɑ and β-Receptor Blockers
Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is clinically...