Propranolol kinetics in plasma from severely burned adults

Area of Science:

• Pharmacology and Critical Care Medicine

Background:

• Elevated heart rate is common in severely burned adults.
• Propranolol is used to manage heart rate in this population, but optimal dosing is unclear.

Purpose of the Study:

• To determine the most effective propranolol dosing strategy for heart rate reduction in adults with severe burns (≥30% total body surface area).

Main Methods:

• 26 adult patients with severe burns were randomized into placebo, Q6, Q8, or Q24 propranolol dosing groups.
• Plasma propranolol concentrations, heart rate, and blood pressure were monitored over two dosing periods.
• Statistical analysis used one-way ANOVA with post-hoc tests.

Main Results:

• Heart rates were 86±2 bpm (Q6), 93±3 bpm (Q8), and 90±4 bpm (Q24).
• The Q8 group showed significantly higher heart rate than the Q6 group (p=0.0001).
• Plasma propranolol concentrations were higher with Q6 dosing compared to Q8 dosing (p=0.02).

Conclusions:

• Both Q6 and Q24 propranolol dosing strategies achieved similar heart rate reduction.
• The Q8 dosing strategy was less effective in controlling heart rate.
• Q6 dosing is recommended for sustained heart rate reduction in severely burned adults.