title: A survey of the use of propranolol in burn centers: Who, what, when, why.
abstract: BACKGROUND
  Many burn centers utilize propranolol in both adult and pediatric burn patients to attenuate the hypermetabolic response related to thermal injury despite the relative paucity of data in adults compared to children. The purpose of this study was to identify practice patterns related to propranolol, for which groups it is being used, length of use, and the intended benefit.
  
  
  METHODS
  A 17 question survey regarding the use of propranolol was distributed to burn centers listed in the ABA website with a link to provide anonymous responses.
  
  
  RESULTS
  A 31% response rate was achieved. Results demonstrated 60.5% use propranolol while 39.5% do not. Use in both adult and pediatric patients was reported in 82% of centers. The majority of centers (60.8%) initiate propranolol in patients with >20% TBSA burns. The drug is continued while inpatient for most adults (43%) with only 10% continuing treatment up to 6 months vs. rates of 17.6% long term outpatient use in pediatric patients. Drug dosing ranged from 10 to 40mg in adults and 0.1mg/kg to 5mg/kg in pediatric patients dosed twice daily to four times daily with 25% and 40% titrating the dose to a reduced heart rate respectively. Propranolol was felt to improve outcomes in 56% of responses while 39% were "unsure".
  
  
  CONCLUSIONS
  The majority of centers use propranolol for both adult and pediatric patients despise the lack of randomized studies in adult populations. A wide variation of practice patterns highlights the need for further study in regard to patient outcomes, duration of therapy, and dosing to drive consensus guidelines.
authors: Vanderbilt University Medical Center 1121 Medical Center Drive Nashville, TN 37232-7175, USA. Electronic address: michal.t.lecompte@vanderbilt.edu.
authors: Michael Thomas
authors: MT
authors: LeCompte
authors: Vanderbilt University Medical Center 1211 Medical Center Dr. VUH 11S Room 11234 Nashville, TN 37232-7175, USA. Electronic address: lisa.rae@vanderbilt.edu.
authors: Lisa
authors: L
authors: Rae
authors: Vanderbilt University Medical Center 1211 Medical Center Dr. VUH 11S Room 11234 Nashville, TN 37232-7175, USA; University of South Alabama Medical Center 2451 Fillingim St, Suite 10-I Mobile AL 36617, USA. Electronic address: skahn@health.southalabama.edu.
authors: Steven Alexander
authors: SA
authors: Kahn
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000553:Ambulatory Care; D001291:Attitude of Health Personnel; D001830:Body Surface Area; D002053:Burn Units; D002056:Burns / Q000188:drug therapy*; D002675:Child, Preschool; D006760:Hospitalization; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011433:Propranolol / Q000627:therapeutic use*; D066231:Surgeons; D011795:Surveys and Questionnaires; D013997:Time Factors; D015599:Trauma Severity Indices; D014481:United States
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol
keywords: Burn; Hypermetabolic; Injury; Pediatric; Propranolol; Survey