• Ashley N Guillory, David N Herndon, Michael B Silva, Clark R Andersen, Erge Edgu-Fry, Oscar E Suman, and Celeste C Finnerty.
• 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.
• Burns. 2017 Sep 1; 43 (6): 1168-1174.

ObjectivesThe aim of this study was to determine the appropriate propranolol dosing strategy for reducing heart rate in severely burned adults.MethodsA 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.ResultsHeart 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).ConclusionsHeart 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.Copyright © 2016. Published by Elsevier Ltd.

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