Efficacy of Propranolol in Traumatic Brain Injury Patients Admitted to the ICU: A Prospective, Randomized, Triple-Blind Study

Beta-blockers have shown promise as a treatment to improve patient prognosis following traumatic brain injury (TBI), although the exact mechanism by which they might confer this benefit remains unknown. At the clinical level, several retrospective cohort studies, prospective cohort studies, small prospective clinical trials, and various reviews and meta-analyses suggest that beta-blockers may be associated with an improved prognosis in patients with TBI. Furthermore, the optimal timing, dosage, and duration of beta-blocker treatment remain uncertain. This means there is still uncertainty regarding the overall efficacy of beta-blockade in patients with TBI, as well as the specifics of patient selection, drugs, dosages, routes of administration, and physiological targets. In summary, the use of beta-blockers in patients with TBI appears to be associated with reduced mortality at the time of ICU discharge, as well as better long-term functional outcomes. However, the lack of high-quality scientific evidence clearly limits the ability to make a generalized recommendation regarding the use of beta-blockers in these patients. Therefore, further clinical trials are needed to analyze the effect of beta-blockers on mortality and short- and long-term functional outcomes in patients with TBI admitted to an Intensive Care Unit (ICU).