The Effectiveness and Safety of Beta Antagonists in Patients With Burns: An Updated Meta-Analysis

Abstract

AimsThe purpose of this systematic review was to assess the safety and effectiveness of beta antagonists for improving clinical care in burn patients, compared to placebo.MethodsArticles from randomized-controlled trials were identified by a literature search on PubMed and Cochrane. We included relevant trials involving patients with burn. Trials were eligible if they evaluated propranolol and compared to usual care or placebo. We conducted a meta-analysis using a random-effects model.ResultsA total of 2114 patients were included from 14 RCTs. Beta-blocker-treated patients had decreased heart rates (WMD = -14.73, 95% CIs = [-19.14, -10.32]), mean arterial pressure (WMD = -2.76, 95% CIs = [-3.81, -1.70]), rate pressure product (WMD = -1.13, 95% CIs = [-1.56, -0.71]), reduced time for wound healing (WMD = -5.08, 95% CIs [-8.97, -1.18]), and lower resting energy expenditure (WMD = -168.83, 95% CIs [-232.03, -105.63]). However, use of beta-blockers did not reduce mortality rate (WMD = 0.98, 95% CIs [0.68, 1.41]), incidence of sepsis (RR = 0.82, 95% CIs = [0.50, 1.35]), or length of stay in hospital (WMD = -1.50, 95% CIs [-4.76, 1.77]) compared with placebo.ConclusionOur findings indicate that the administration of propranolol to burned patients does not contribute to increased mortality rates, reduced length of hospital stays, or heightened sepsis occurrence. It demonstrates a protective effect on heart function by reducing heart rate, resting energy expenditure, rate pressure product, and wound healing. More randomized-controlled and multi-center studies are needed to effectively establish the use of beta antagonists in burn patients.

Keywords: beta antagonist; beta-blockers; burns; catecholamine; propranolol.