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

Abstract

Aims: The 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.

Methods: Articles 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.

Results: A 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.

Conclusion: Our 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.