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.
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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