• Critical Care Committee Article Review: Early proporanolol after traumatic brain injury is associated with lower mortality (June 2018)

    CME 1 CME Credit(s)

    Learning Objectives:

    While the authors suggest early propranolol (within the initial 24hrs) after TBI has promising outcomes, it is not clear if this protocol would have same apparent benefit in all moderate/severe TBI patients.  This study adds to the long list of studies that “suggest” benefit but fails to demonstrate it conclusively. Further studies to determine the optimal dosing regimen, potential complications and limitations, and the patient population most likely to benefit are still needed.

    Impact Statement:

    Traumatic Brain Injury (TBI) accounts for up to 30% of all traumatic deaths and contributes to substantial long-term disability.  Β-adrenergic receptor blockers may blunt the catecholamine surge, excitatory neurotransmitters and inflammatory cascade to significantly impact post-head injury morbidity and mortality.  Propranolol appears to have more of a beneficial effect that the more selective B blockers and was therefore used in this study.

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    This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint providership of the American College of Surgeons and the American Association for the Surgery of Trauma. The American College of Surgeons is accredited by the ACCME to provide continuing medical education (CME) for physicians.

    AMA PRA Category 1 Credits™

    The American College of Surgeons designates this journal-based activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Of the AMA PRA Category 1 Credits™ listed above, a maximum of 1 credit meets the requirements for Self-Assessment.

    Of the AMA PRA Category 1 Credits™ listed above, a maximum of 1 credit meets the requirements for Surgical Critical Care.

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