Beta Blockade in Critical Injury

Beta-blockade Reduces Catabolism in Severely Injured Trauma Patients

Critically injured patients endure a period of hypermetabolism/catabolism after being resuscitated. The metabolic cost of this may be measured in loss of lean body mass, poor wound healing, susceptibility to infection and long hospital stays. While there have been some data to suggest that hypermetabolism can be ameliorated in burn patients by beta blockade, to our knowledge, a prospective trial in trauma patients has not yet been done. Our hypothesis is that nonselective beta blockade will reduce catabolism, improve glucose control, blunt loss of lean body mass, decrease infections and improve outcome in a cohort of critically injured patients.

Inclusion Criteria:

• ISS>25, stable at 48 hours after injury
• Fully resuscitated
• Ventilated

Exclusion Criteria Include:

• Intracranial hypertension requiring active treatment
• Hypotension/Pressors
• Already on beta blocker for a standard indication