Effect of Heart Rate Control with Esmolol on Hemodynamic and Clinical Outcomes in Patients with Septic Shock: A Randomized Clinical Trial

摘要

Septic shock is associated with high plasma catecholamine levels and tachycardia, which are independently associated with poor outcomes in critically ill patients. Beta blockade may help prevent sympathetic overstimulation, which may, in turn, enhance myocardial function and improve outcomes. This single-center, open-label, randomized phase 2 study evaluated esmolol as a therapeutic intervention for heart rate control involvingpatients in septic shock with a heart rate greater than 95 beats/min, requiring high-dose norepinephrine. After 24 hours of hemodynamic optimization, 77 patients were randomly assigned to receive a continuous infusion of esmolol titrated to maintain a heart rate between 80 beats/min and 94 beats/min for their intensive care unit stay, and 77 patients to standard treatment.