Adrenergic blockade in adult burns patients

Post burn injury, survivors undergo a “hypermetabolic” response resulting in loss of muscle mass and increase in fat tissue, increased cardiac work, and delays in wound healing. Consequently these patients have weakness, increased length of hospital stay decreased functional ability and delayed return to work rates. One way to counteract this problem is by pharmacological blockade ie using medication to block the hypermetabolic response. One drug that has been trialled extensively in paediatrics are beta - blockers which decrease the work of the heart. The studies in children have shown these drugs can improve donor site and graft healing, attenuate muscle mass loss, prevent loss of lean muscle mass, improve immune function and decrease in the high temperature, high heart rate, increased cardiac work, and fatty infiltration of the liver. There have been two small trials in adults who did not blind investigators, investigate long term factors and included patients with burns less than 30% total body surface area. We plan to complete a single blinded, randomized trial on beta -adrenergic blockade in large severe adult burns patients investigating a number of important long term outcomes including lean muscle mass, cardiac function, wound healing, exercise capacity and metabolic profile. The specific aim is to investigate whether Propranolol)1mg/kg/day) a nonselective beta(1,) beta(2)-receptor antagonist, can prevent the loss of lean muscle mass and improve cardiac function, wound healing, exercise capacity and metabolic profile following severe thermal injury