Ultrashort-acting β-blockers lower mortality in patients with septic shock: Study
Japan: The use of ultrashort-acting β-blockers (such as esmolol and landiolol) significantly lowered 28-day mortality in sepsis patients with persistent tachycardia despite initial resuscitation, finds a recent study in the journal Chest.
Historically, the use of β-blockers is relatively contraindicated for a septic shock as they may lead to cardiac suppression. On the other hand, there is an increasing interest in the β-blockers use for the treatment of patients with sepsis with persistent tachycardia despite initial resuscitation.
Osamu Nishida, Fujita Health University School of Medicine, Aichi, Japan, and colleagues, therefore, aimed to determine whether ultrashort-acting β-blockers such as esmolol and landiolol improve mortality in patients with sepsis with persistent tachycardia despite initial resuscitation in a systematic review and meta-analysis
For this purpose, the researchers searched the online databases for randomized controlled trials (RCTs) that compared the mortality of patients with sepsis and septic shock treated with esmolol or landiolol. Seven RCTs with a pooled sample size of 613 patients were included. Of these, six RCTs with 572 patients reported 28-day mortality.
Key findings of the study include:
- Esmolol or landiolol use in patients with sepsis and septic shock was significantly associated with lower 28-day mortality (risk ratio, 0.68).
- Unimportant heterogeneity was observed (I2 = 31%).
- The absolute risk reduction and number of patients to be treated to prevent one death were 18.2% and 5.5, respectively.
"Our findings show that the use of ultrashort-acting β-blockers such as esmolol and landiolol in patients with sepsis with persistent tachycardia despite initial resuscitation was associated with significantly lower 28-day mortality," concluded the authors.
Reference:
The study titled, "Effect of Ultrashort-Acting β-Blockers on Mortality in Patients With Sepsis With Persistent Tachycardia Despite Initial Resuscitation: A Systematic Review and Meta-analysis of Randomized Controlled Trial," is published in the journal Chest.
DOI: https://journal.chestnet.org/article/S0012-3692(21)00035-0/fulltext
