Beta-Blocker Seems to Improve Outcomes in Septic Shock — Physician’s First Watch
Beta-Blocker Seems to Improve Outcomes in Septic Shock
By Joe Elia
Use of esmolol, a short-acting beta-blocker, stabilizes heart rates and improves outcomes in patients with septic shock and increased heart rates, according to a phase II trial in JAMA.
Researchers randomized some 150 patients either to continuous infusion of esmolol or usual care for the length of their stay in the ICU. At study entry, all had heart rates of at least 95/min.
Throughout their stays, the esmolol recipients maintained heart rates between 80 and 94, which were significantly lower than among controls. The esmolol group also maintained target mean arterial pressure despite a marked reduction in need for norepinephrine. Mortality at 28 days was 49% with esmolol and 81% with usual care.
An editorialist reminds readers that beta-blockers are not without risks of their own, and he calls for trials to define the group of patients most likely to benefit from their use in these circumstances.