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Forrest Gump syndrome. The effect of propranolol in combating hypercatabolism
Forrest Gump syndrome. The effect of propranolol in combating hypercatabolism
Marco A. Garnica-Escamilla 1 
, Kristhian R. Osuna-Zamora 2, Raisa P. Iñiguez-Cereno 3, Elizabeth Vital-Montiel 4, David Márquez-Domínguez 5, Claudia I. Serrano-Becerril 6, Jaqueline Morales-Nuño 7, Julieta Garnica-Escamilla 8, Armando V. García-Monzalvo 9
1 Departamento de Anestesia, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Secretaría de Salud, México; 2 Department of Medical-Surgical Emergency, Hospital General Regional No.1, Instituto Mexicano del Seguro Social, Querétaro, Mexico; 3 Department of Medical-Surgical Emergency, Hospital General Regional No.2 “El Marqués”, Instituto Mexicano del Seguro Social, Querétaro, México; 4 Department of Medical-Surgical Emergency, Hospital Regional Gral. Ignacio Zaragoza, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, México; 5 Highly Specialized Department of Regional Anesthesia, Secretaría de Salud, Mexico City, Mexico; 6 Anesthesia Division Headquarters. Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico; 7 División de Anestesiología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra. Secretaría de Salud. Ciudad de México, México; 8 Outpatient Clinic, Centro de Salud T-III Carmen Serdán, Secretaría de Salud, Mexico City, Mexico; 9 Anesthesiology Department, Hospital General La Perla, Instituto de Salud del Estado de Mexico, Nezahualcoyotl, State of Mexico, Mexico
*Correspondence: Marco A. Garnica-Escamilla. Email: teranestmarco@yahoo.com.mx
Abstract
Forrest Gump, personified actor Tom Hanks, possessed incredible kinesthetic adaptability that enabled him to develop physical skills such as running, as well as the focus and concentration needed to play ping pong or reload weapons very quickly-all of which were caused by hypermetabolism. Endogenous catecholamines are primary mediators of the hypermetabolic response to burns. Consequently, the structure and function of essential organs such as muscle, skin, the heart, the immune system, and the liver are compromised, contributing to multiple organ failure, sepsis, and mortality. This results in increased energy expenditure at rest, rapid muscle loss, and high rates of depression, anxiety, and post-traumatic stress disorder, thereby delaying the recovery process in burn patients-one of the main reasons for poor recovery. Propranolol, a beta-blocker, is one of the treatments used to mitigate the effects of elevated catecholamines by blocking β-adrenergic receptors. Its other pleiotropic effects have been proposed as an effective strategy for reducing catabolism, and it has been used as a therapy to reduce the deleterious effects of the hypermetabolic response, with proven effectiveness.
Keywords: Propranolol. Hypercatabolism. Burns. Catecholamines.
