title: β-Adrenergic blockade does not impair the skin blood flow sensitivity to local heating in burned and nonburned skin under neutral and hot environments in children.
abstract: We tested the hypothesis that propranolol, a drug given to burn patients to reduce hypermetabolism/cardiac stress, may inhibit heat dissipation by changing the sensitivity of skin blood flow (SkBF) to local heating under neutral and hot conditions.
  
  
  
  In a randomized double-blind study, a placebo was given to eight burned children, while propranolol was given to 13 burned children with similar characteristics (mean±SD: 11.9±3 years, 147±20 cm, 45±23 kg, 56±12% Total body surface area burned). Nonburned children (n=13, 11.4±3 years, 152±15 cm, 52±13 kg) served as healthy controls. A progressive local heating protocol characterized SkBF responses in burned and unburned skin and nonburned control skin under the two environmental conditions (23 and 34°C) via laser Doppler flowmetry.
  
  
  
  Resting SkBF was greater in burned and unburned skin compared to the nonburned control (main effect: skin, P<.0001; 57±32 burned; 38±36 unburned vs 9±8 control %SkBFmax). No difference was found for maximal SkBF capacity to local heating between groups. Additionally, dose-response curves for the sensitivity of SkBF to local heating were not different among burned or unburned skin, and nonburned control skin (EC50, P>.05) under either condition.
  
  
  
  Therapeutic propranolol does not negatively affect SkBF under neutral or hot environmental conditions and further compromise temperature regulation in burned children.
authors.affiliation: Shriners Hospitals for Children, The University of Texas Medical Branch, Galveston, TX, USA.|Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: Eric
authors.identifier: 0000-0002-4657-8292
authors.initials: E
authors.lastname: Rivas
authors.affiliation: College of Nursing and Health Sciences, Valdosta State University, Valdosta, GA, USA.
authors.forename: Serina J
authors.initials: SJ
authors.lastname: McEntire
authors.affiliation: Shriners Hospitals for Children, The University of Texas Medical Branch, Galveston, TX, USA.|Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: David N
authors.initials: DN
authors.lastname: Herndon
authors.affiliation: Shriners Hospitals for Children, The University of Texas Medical Branch, Galveston, TX, USA.|Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Mlcak
authors.affiliation: Shriners Hospitals for Children, The University of Texas Medical Branch, Galveston, TX, USA.|Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: Oscar E
authors.initials: OE
authors.lastname: Suman
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D002056:Burns; D002648:Child; D004311:Double-Blind Method; D006361:Heating; D006358:Hot Temperature; D006801:Humans; D017078:Laser-Doppler Flowmetry; D011433:Propranolol / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D012039:Regional Blood Flow / Q000187:drug effects*; D012867:Skin / Q000098:blood supply* / Q000293:injuries* / Q000473:pathology
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol
keywords: burn injury; laser Doppler flowmetry; microcirculation; pediatrics; skin blood flow perfusion; temperature regulation