Ashley N Guillory1, David N Herndon2, Michael B Silva2, Clark R Andersen2, Erge Edgu-Fry2, Oscar E Suman2, Celeste C Finnerty3. 1. Department of Surgery, University of Texas Medical Branch, Galveston, TX, United States; Institute for Translational Sciences and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston, TX, United States; Shriners Hospitals for Children(®) - Galveston, Galveston, TX, United States. 2. Department of Surgery, University of Texas Medical Branch, Galveston, TX, United States; Shriners Hospitals for Children(®) - Galveston, Galveston, TX, United States. 3. Department of Surgery, University of Texas Medical Branch, Galveston, TX, United States; Institute for Translational Sciences and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston, TX, United States; Shriners Hospitals for Children(®) - Galveston, Galveston, TX, United States. Electronic address: ccfinner@utmb.edu.
Abstract
OBJECTIVES: The aim of this study was to determine the appropriate propranolol dosing strategy for reducing heart rate in severely burned adults. METHODS: A total of 26 patients (≥18 years) with burns covering ≥30% of the total body surface area were included in this IRB-approved study. Plasma propranolol concentrations were determined in a placebo group (n=10) or following one of three dosing strategies: Q6 (n=4), Q8 (n=6), and Q24 (n=6). Blood was collected just before dosing and at regular intervals over two dosing periods with corresponding heart rate and blood pressure recordings. Statistical significance was determined by one-way ANOVA followed by the appropriate post-hoc test. RESULTS:Heart rate was 86±2 bpm for Q6, 93±3 bpm for Q8, and 90±4 bpm for Q24. The Q8 group had a significantly higher heart rate than the Q6 group (p=0.0001). Plasma propranolol concentrations were significantly higher in the Q6 dosing strategy than in the Q8 dosing strategy (p=0.02). CONCLUSIONS:Heart rate can be decreased to a similar degree with Q6 and Q24 dosing strategies, with the Q8 dosing strategy being less effective. Q6 dosing is recommended to maintain reduced heart rate throughout dosing periods.
RCT Entities:
OBJECTIVES: The aim of this study was to determine the appropriate propranolol dosing strategy for reducing heart rate in severely burned adults. METHODS: A total of 26 patients (≥18 years) with burns covering ≥30% of the total body surface area were included in this IRB-approved study. Plasma propranolol concentrations were determined in a placebo group (n=10) or following one of three dosing strategies: Q6 (n=4), Q8 (n=6), and Q24 (n=6). Blood was collected just before dosing and at regular intervals over two dosing periods with corresponding heart rate and blood pressure recordings. Statistical significance was determined by one-way ANOVA followed by the appropriate post-hoc test. RESULTS: Heart rate was 86±2 bpm for Q6, 93±3 bpm for Q8, and 90±4 bpm for Q24. The Q8 group had a significantly higher heart rate than the Q6 group (p=0.0001). Plasma propranolol concentrations were significantly higher in the Q6 dosing strategy than in the Q8 dosing strategy (p=0.02). CONCLUSIONS: Heart rate can be decreased to a similar degree with Q6 and Q24 dosing strategies, with the Q8 dosing strategy being less effective. Q6 dosing is recommended to maintain reduced heart rate throughout dosing periods.
Authors: Marc G Jeschke; Gerd G Gauglitz; Gabriela A Kulp; Celeste C Finnerty; Felicia N Williams; Robert Kraft; Oscar E Suman; Ronald P Mlcak; David N Herndon Journal: PLoS One Date: 2011-07-18 Impact factor: 3.240
Authors: David Herndon; Karel D Capek; Evan Ross; Jayson W Jay; Anesh Prasai; Amina El Ayadi; Guillermo Foncerrada-Ortega; Elizabeth Blears; Christian Sommerhalder; Kara McMullen; Dagmar Amtmann; Robert Cox; Gabriel Hundeshagen; Kristofer Jennings; Linda E Sousse; Oscar E Suman; Walter J Meyer; Celeste C Finnerty Journal: Ann Surg Date: 2018-09 Impact factor: 12.969