propranolol in burns
TRANSCRIPT
Use of Propranolol in Burns
Tan Hon LiangAnaesthesia-Critical Care
STRESSCatecholamine
Glucocorticoids
The Bad Stuff
Cardiac StressCatabolism
Wound Healing
Maybe the Good StuffPropranolol
Propranolol - Good Stuff
Propranolol - Good Outcomes?
Not All Harmless
Unopposed alpha actionMesenteric ischemia
Sounds Goodbut
Will We Truly Know Soon?
250 - 2017
160 - 2017
DoseTarget End Point
How Soon
Type of PatientTBSA Extent
Type of Burns
Treatment Duration
Soon?I Don’t Think So!
So What Do I Do?
Type of PatientAdult TBSA Extent
>30%
Type of BurnsAll types
Target End Point20% of max
HR
DoseEscalating
Treatment DurationAs long as I can
How SoonAs soon
as possible
Summary
Propranololchildren: good evidenceadults: some evidence
Use Propranololbut be careful
Start early Dose as tolerated
Target 20% of Max HR
