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Effect of Propranolol Administration on Hemodynamic and Metabolic Responses of Burned Pediatric Patients
- Source :
- Annals of Surgery. 208:484-492
- Publication Year :
- 1988
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 1988.
-
Abstract
- Hypermetabolism, increased heart rate, and lipolysis are responses to high catecholamine levels associated with burn injury. This study tests the hypothesis that adrenergic beta blockade in burns could reduce myocardial work, lipolysis, and negative nitrogen balance without adversely affecting cardiac or metabolic function. Eighteen patients with burns of 70 +/- 3% total burn surface area (TBSA) (Mean +/- SEM), were studied after a 5-day infusion of 2 mg/Kg of intravenous (I.V.) propranolol infusion every 24 hours without their cardiac output or resting energy expenditure being adversely reduced. Heart rate, left ventricular work, and rate pressure product were significantly reduced by 20, 22, and 36%, respectively (P less than 0.05). Plasma glucose, free fatty acids, triglycerides, and insulin levels remained unchanged. The rate of urea production, however, was significantly increased by 54 +/- 12% in fasted patients, and to a much lesser 12 +/- 2% in fed patients. The marked decrease in myocardial work afforded by propranolol administration may be of clinical benefit in the treatment of large burns. Variations in drug dosage and feeding regimens will, however, need to be perfected to limit catabolic effects.
- Subjects :
- Blood Glucose
Cardiac output
medicine.medical_specialty
Adolescent
Hemodynamics
Blood Pressure
Propranolol
Fatty Acids, Nonesterified
Heart Rate
Internal medicine
Heart rate
Humans
Insulin
Urea
Medicine
Lipolysis
Resting energy expenditure
Child
Infusions, Intravenous
business.industry
Stroke Volume
Fasting
Oxygen
Rate pressure product
Endocrinology
Child, Preschool
Anesthesia
Hypermetabolism
Surgery
Burns
Energy Metabolism
business
Research Article
medicine.drug
Subjects
Details
- ISSN :
- 00034932
- Volume :
- 208
- Database :
- OpenAIRE
- Journal :
- Annals of Surgery
- Accession number :
- edsair.doi.dedup.....f5309967fd389b95daeb2eda5c4b12ac