Propranolol and Oxandrolone Therapy Accelerated Muscle Recovery in Burned Children

Abstract

Rehabilitative exercise training improves body composition, muscle function, and cardiorespiratory fitness in children recovering from severe burns. Oxprop therapy augments RET-mediated improvements in muscle strength, power, and protein turnover.

Reduced Postburn Hypertrophic Scarring and Improved Physical Recovery With Yearlong Administration of Oxandrolone and Propranolol

“…These results demonstrate benefits of the long-term, combined administration of propranolol and oxandrolone. The present findings add to the already established benefits of the individual administration of oxandrolone and propranolol, in addition to the improved growth with the combined therapies 8,10,12–15,17,19,26,28–32,35,41,43–47,49,50,52,79–81 .…”

“…The patients in the treatment group were also found to have greater improvement in mental health. These findings may result from improved healing with OxProp—these patients have resumed growing 41 and have more lean mass and muscle strength 28 ; this would translate directly into an easier ability to function, allowing the patient to resume more daily activity and improving mental outlook.…”

“…First, amelioration of the long-term adrenergic stress associated with burns improves anthropometric measures, specifically lean mass, 16 as does treatment with oxandrolone. 32 This increase in lean mass, when contrasted with the muscle catabolism of untreated patients, contributes to an overall increase in functional strength, 28 thereby increasing physical function. 88 Since patients treated with the combination of oxandrolone and propranolol reported improved general health, perhaps the increase in activity level creates a beneficial effect on scar tissue, such as the scar being stretched more because of increased activity.…”

“…Patients were between the ages of 6 months and 18 years at the time of burn, with burns over ≥30% of TBSA, and required surgery for skin grafting after scald, flame, or electrical burn. This study, which is part of an ongoing evaluation of the long-term administration of anti-adrenergic, anti-catabolic, or anabolic agents, 8,11–14,17,19,28–32,35,41–60 was approved by the University of Texas Medical Branch Institutional Review Board (ClinicalTrials.gov number, NCT00675714). Patients, or their legal caregiver if younger than 18 years of age, consented to participate in this trial; children between the ages of 7 and 18 assented to participate in the protocol as well.…”

Persistent inflammation, immunosuppression, and catabolism and the development of chronic critical illness after surgery

“…(49) Dysfunctions in substrate utilization (rather than true deficits) are likely a key component to this catabolic state, meaning that adequate nutrition and/or physical rehabilitation alone are likely not sufficient therapies. Decreases in the metabolic/catabolic burden via administration of agents, such as propranolol and oxandrolone, have substantial therapeutic benefit in pediatric burn patients (50–52) but need further study in a broader, adult population of CCI subjects. Further insight into the mechanisms driving persistent catabolism after CCI are necessary to develop targeted therapies to reverse or limit PICS-associated muscle wasting and improve functional outcomes in any future multi-modality therapeutic approaches.…”