Should β-blockers be used in septic shock?
نویسندگان
چکیده
Methods Objective: The objective of the study was to investigate the effect of the short-acting β-blocker esmolol in patients with severe septic shock. Design: An open-label, randomized phase 2 study was conducted between November 2010 and July 2012. Setting: The study was conducted in a university hospital ICU. Subjects: Patients were in septic shock with a heart rate of 95/minute or higher requiring high-dose norepinephrine to maintain a mean arterial pressure of 65 mmHg or higher. Intervention: We randomly assigned 77 patients to receive a continuous infusion of esmolol titrated to maintain a heart rate between 80/minute and 94/minute for their ICU stay and 77 patients to standard treatment.
منابع مشابه
Beta-block the septic heart.
OBJECTIVES Cardiac depression is a well-described manifestation of the sepsis syndrome. An important underlying mechanism is the attenuation of the adrenergic response at the cardiomyocyte level. By reducing their cell-specific function (contractility), the cardiomyocytes reduce their energy expenditure. Consequently, the cardiac myocytes survive in a hibernation-like state as long as intracell...
متن کاملβ-Adrenergic receptor and signaling cascade
Sepsis, despite recent therapeutic progress, still carries unacceptably high mortality rates. The adrenergic system, a key modulator of organ function and cardiovascular homeostasis, could be an interesting new therapeutic target for septic shock. β-Adrenergic regulation of the immune function in sepsis is complex and is time dependent. However, β2 activation as well as β1 blockade seems to dow...
متن کاملTime to re-think the use of dobutamine in sepsis
Dobutamine is commonly used worldwide and included in the protocol for early goal-directed therapy (EGDT). Since the use of dobutamine in EGDT was reported, it has been considered to be an important component, especially in the treatment of septic patients with myocardial dysfunction. However, it is questionable whether dobutamine improves the mortality of sepsis and septic shock. In three rece...
متن کاملβ-blockers in septic shock: are we there yet?
Septic shock is characterized by circulatory collapse and diminished tissue perfusion, leading to organ dysfunction in the setting of systemic infection. The mechanisms of septic shock are incompletely understood; moreover, its incidence is increasing, and its mortality remains unacceptably high. In addition to antimicrobial and supportive treatments, no other therapy has a survival benefit, de...
متن کاملOptimal Aminoglycoside Therapy Following the Sepsis: How Much Is Too Much?
Severe sepsis and septic shock are major problems as the result of high rates morbidity andmortality in intensive care units (ICUs). In the presence of septic shock, each hour of delay inthe administration of effective antibiotics is associated with a measurable increase in mortality.Aminoglycosides are effective broad-spectrum antibiotics that are commonly used in ICUs forthe treatment of life...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 18 شماره
صفحات -
تاریخ انتشار 2014