Burns Open (Jul 2023)

The effect of propanolol and metformin on clinical outcomes in burns patients: A systematic review and meta-analysis

  • I. Nyoman Putu Riasa,
  • Bertha Kawilarang

DOI
https://doi.org/10.1016/j.burnso.2023.04.002
Journal volume & issue
Vol. 7, no. 3
pp. 76 – 84

Abstract

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Backgrounds: Due to the scarcity of available studies, the inconsistency in the use of β- blocker and biguanide and the uncertainty of their effect on clinical outcome in burn patients still exist. This systematic review and meta-analysis aimed to determine the effects of propranolol and metformin administration on the clinical outcomes of hospitalized patients with burns. Methods: To identify potential articles investigating propranolol and metformin effect in burn patients, a comprehensive search was conducted using three databases (PubMed, Web of Science, and Cochrane library) up to December 4th, 2022. A meta-analysis was conducted using Review Manager Software version 5.4, and the pooled effect estimate was generated as a mean difference (MD) and risk ratio (RR) with a 95% confidence interval (CI) and two- sided p-value. Results: Of nine studies, six RCT studies were included in the meta-analysis. Due to various measures and limited studies, a meta-analysis could not be performed in metformin- investigating studies. In regard to the administration of propranolol, we found that there was no statistically significant difference in the pooled estimate of mortality (RR = 1.01, 95 %CI [0.67, 1.52], p = 0.95) and length of hospital stay (MD = −1.75, 95 %CI [−9.79, 6.29], p = 0.67). Hypotension and bradycardia were the two most common adverse events reported in the studies. Conclusions: Albeit the use of propranolol and metformin demonstrated no significant difference in terms of mortality and length of hospital stay, this study corroborated findings from the previous studies regarding the beneficial effects of these two drugs. However, additional clinical outcome data are required to create a consensus and formulate practice guidelines on the optimal anabolic and anti-catabolic agents to use, indication for initiation, and duration of treatment; thus, further RCT with larger sample size are warranted to confirm these finding.

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