P0092 / #497: BEHAVIOR OF CARDIAC OUTPUT WITH THE USE OF PROPRANOLOL IN PHARMACOLOGICAL NUTRITIONAL SUPPORT OF PEDIATRICS WITH THERMAL INJURIES IN A BURN CENTRE

Abstract

Aims & Objectives: Propranolol as an adrenergic antagonist, allows the reduce of hypermetabolic response. The burn injury induces two responses, Ebb or Hypodynamic and Phase Flow or Hyperdynamic, this one is characterized by hypermetabolism and hypercatabolism, which is reflected in the increase of cardiac work, degradation of muscle proteins and impaired immune response, finally wasting syndrome and torpid recovery. Dosage of 2mg / kg of weight achieves a decrease in cardiac output about 20% after weeks of use. Determine the behavior of cardiac output, through the measurement of it with ultrasonographic protocols (FOCUS), this method is low cost, easy access, without adverse effects and sequential evaluation can be performed. Methods: Prospective, prolective, longitudinal and descriptive study Patients between 0 days and 17 years 11 months 29 days who were admitted in the Burn Unit during 2019 with more than 10% of body surface area. The effects of propranolol with 2mg / kg of weight are described, in relation to cardiac output. Monitoring ultrasound were performed at admission and a week after treatment was begined, finally at hospital discharge. Electrocardiogram was used to identify rhythm disorders and heart rate monitoring. Finally, the modification of cardiac output with the treatment was plotted. Results: 20 patients were included in this study. A decrease in cardiac output from 20 to 60% was observed among the various etiologies of thermal trauma. Conclusions: The decrease in cardiac output during Flow Phase is an indirect way of modulate the hypercatabolic response that leads to immune wasting, risk of infection, sarcopenia and late recovery.