Cardiac Autonomic Dysfunction in Cardiogenic and Non-Cardiogenic-Triggered Multiple Organ Dysfunction Syndrome (MODS) and the Use of beta-Blockers

摘要

The multiple organ dysfunction syndrome (MODS) is the sequential failure of organ systems after a trigger event (e.g. cardiogenic shock) with a high mortality. beta-blockers are known to ameliorate blunted autonomic function (heart rate variability [HRV]). Our study aimed to characterize potential benefits of beta-blocker therapy in MODS patients. 134 score-defined consecutive patients were assigned to this study. Inclusion criterion was an APACHE II score > 20 at admission to the ICU. Patients were evaluated for B-blocker therapy and followed for 28 days. HRV was calculated according to the international standards. The overall mortality of the assessed cohort was 45/ 134 (34%) after 28 days. The subgroup with B-blocker administration and preserved HRV had the best cumulative survival (5/33 events) whereas the subgroup without B-blockers and the most depressed HRV (21/37 events) had the worst cumulative survival. Our results may suggest that MODS patients with B-blocker treatment may have a lower short-term mortality. Consequently, effectiveness of B-blocker therapy should be validated in a prospective trial.