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

Eric Rivas1,2,3, Serina J McEntire, David N Herndon1,2

  • 1Shriners Hospitals for Children, Galveston, TX.

Journal of Burn Care & Research : Official Publication of the American Burn Association
|June 30, 2017
PubMed

Insights

Propranolol, a beta-blocker, did not increase heat illness risk in burned children during exercise. However, severe burn injuries independently suppressed cardiac function, leading to exercise intolerance in these children.

Area of Science:

  • Pediatric Medicine
  • Exercise Physiology
  • Burn Rehabilitation

Background:

  • Propranolol is frequently prescribed to burned children.
  • The combined effects of propranolol and exercise-heat stress on burned children's thermoregulation and exercise capacity are not well understood.
  • Burn injuries can impact cardiovascular function and exercise tolerance.

Purpose of the Study:

  • To investigate if propranolol combined with exercise-heat stress increases the risk of heat illness and exercise intolerance in burned children.
  • To compare the physiological responses of burned children receiving propranolol, burned children receiving placebo, and nonburned children during exercise in hot conditions.

Main Methods:

  • A randomized, double-blind study involving 20 burned children (10 receiving propranolol, 10 receiving placebo) and a control group of nonburned children.
  • Participants exercised in hot conditions (34.3°C, 26% RH) at 75% of their peak aerobic capacity.
  • Measurements included core and skin temperatures, heat loss, thermal conductance, physiological strain index, exercise duration, and cardiac function metrics.

Main Results:

  • No significant differences were observed in core or skin temperatures, heat loss, thermal conductance, or physiological strain index among the groups.
  • Burned children, regardless of propranolol treatment, exercised for shorter durations and had lower calculated exercise tolerance indices compared to nonburned children.
  • Burned children exhibited lower peak heart rates and higher relative cardiac work rates during exercise, indicating suppressed cardiac function independent of propranolol.

Conclusions:

  • Resting beta-adrenergic blockade with propranolol does not appear to affect the thermoregulation of burned children exercising at similar relative intensities in the heat.
  • Independent of propranolol, suppressed cardiac function in children with severe burn injuries may contribute to exercise intolerance.
  • Further research is needed to understand the long-term implications of altered cardiac function on the physical rehabilitation of burned children.

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