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2017 ; 12
(ä): 11
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Safety and effectiveness of propranolol in severely burned patients: systematic
review and meta-analysis
#MMPMID28265298
Manzano-Nunez R
; García-Perdomo HA
; Ferrada P
; Ordoñez Delgado CA
; Gomez DA
; Foianini JE
World J Emerg Surg
2017[]; 12
(ä): 11
PMID28265298
show ga
BACKGROUND: The objective of this systematic review was to determine the
effectiveness and safety of propranolol compared to placebo or usual care for
improving clinical relevant outcomes in severely burned patients (TBSA >20%).
METHODS: Relevant articles from randomized controlled trials were identified by a
literature search in MEDLINE, EMBASE, and CENTRAL. We included trials involving
patients with a severe burn (>20% of total body surface area affected). Trials
were eligible if they evaluated propranolol and compared to usual care or
placebo. Two investigators independently assessed articles for inclusion and
exclusion criteria and selected studies for the final analysis. We conducted a
meta-analysis using a random-effects model. RESULTS: We included ten studies in
our systematic review. These studies randomized a total of 1236 participants.
There were no significant differences between propranolol and placebo with
respect to mortality (RD -0.02 [95% CI -0.06 to 0.02]), sepsis (RD -0.03 [95% CI
-0.09 to 0.04]), and the overall hospital stay (MD -0.37 [-4.52 to 3.78]).
Propranolol-treated adults had a decrease in requirements of blood transfusions
(MD -185.64 [95% CI -331.06 to -40.43]) and a decreased heart rate (MD -26.85
[95% CI -39.95 to -13.75]). CONCLUSIONS: Our analysis indicates that there were
no differences in mortality or sepsis in severely burned patients treated with
propranolol compared with those who had usual care or placebo. However, the use
of propranolol in these patients resulted in lower requirements of blood
transfusion and lower values of heart rate. The evidence synthesized in this
systematic review is limited to conclude that propranolol reduces the length of
hospital stay among severely burned patients. Future trials should assess the
impact of propranolol on clinically relevant outcomes such as mortality and
adverse events.
|Adrenergic beta-Antagonists/adverse effects/pharmacology/therapeutic use
[MESH]