Short Title:Critical Care
Year, Volume, Issue, Page(s):15, 19, 1,
Study investigated whether wound healing and perioperative hemodynamics are affected by propranolol administration in severely burned adults. Sixty-nine adult patients with burns covering at least 30 percent of their total body surface area received standard burn care, 35 patients with and 34 without (controls) propranolol. Propranolol was administered within 48 hours of burns and given throughout hospital discharge to decrease heart rate by approximately 20 percent from admission levels. Wound healing was determined by comparing the time between grafting procedures. Blood loss was determined by comparing pre- and post-operative hematocrit while factoring in operative graft area. Data were collected between first admission and first discharge. Demographics, burn size, and mortality were comparable in the control and propranolol groups. Patients in the propranolol group received an average propranolol dose of 3.3 mg/kg/day. Daily average heart rate over the first 30 days was significantly lower in the propranolol group. The average number of days between skin grafting procedures was also lower in propranolol patients (10 days) than in control patients (17 days), indicating faster donor site healing time in the propranolol group. Packed red blood cell infusion was similar between groups (control 5.3 units versus propranolol 4.4 units). Propranolol was associated with 5- to 7-percent improvement in perioperative hematocrit during grafting procedures of 4,000 to 16,000 centimeters squared compared to controls. Results indicate that administration of propranolol during the acute hospitalization period diminished blood loss during skin grafting procedures and improved wound healing in severely burned adults.