Beta-blocker use in severe sepsis and septic shock: a systematic review

  title={Beta-blocker use in severe sepsis and septic shock: a systematic review},
  author={Filippo Sanfilippo and Cristina Santonocito and Andrea Morelli and Pierre Foex},
  journal={Current Medical Research and Opinion},
  pages={1817 - 1825}
Abstract Objective: Recent growing evidence suggests that beta-blocker treatment could improve cardiovascular dynamics and possibly the outcome of patients admitted to intensive care with severe sepsis or septic shock. Design: Systematic review. Data sources: MEDLINE and EMBASE healthcare databases. Review methods: To investigate this topic, we conducted a systematic review of the above databases up to 31 May 2015. Due to the clinical novelty of the subject, we also included non-randomized… 

β-Blockers in sepsis: protocol for a systematic review and meta-analysis of randomised control trials

This systematic review will evaluate the effects of β-blockers in adults with sepsis, comprehensively summarising and appraising the available evidence from randomised control trials, to help clinicians treating patients withSepsis to understand the potential role ofβ-blockade, and inform future research on this topic.

Beta-Blockers, Tachycardia and Survival Following Sepsis- An Observational Cohort Study.

  • D. GuzShira Buchritz T. Avni
  • Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2021
Chronic BB therapy was associated with decreased mortality in patients hospitalized with sepsis in internal medicine wards exhibiting absolute and relative tachycardia.

Beta-blocker treatment in the critically ill: a systematic review and meta-analysis

A potential outcome benefit of β-blocker treatment in critical illness exists according to the current review and meta-analysis and further studies, preferably large RCTs, are needed to answer the questions concerning timing and choice of α-blockers, patient selection, and optimal hemodynamic targets.

Evaluation of the safety and efficacy of beta blockers in septic patients: a randomized control trial

The role of intravenous beta blockers in sepsis patients is supported by decreasing heart rate without affecting the hemodynamics, in addition to decreasing 28-day mortality and ICU stay.

Study into the reversal of septic shock with landiolol (beta blockade): STRESS-L Study protocol for a randomised trial

STRESS-L is a randomised, open-label, non-blinded clinical trial enrolling a total of 340 patients with septic shock as defined by Sepsis-3 consensus definition and a tachycardia after vasopressor treatment of at least 24 hours, which will inform current clinical practice guidelines.

The association between premorbid beta blocker exposure and mortality in sepsis—a systematic review

It is suggested that β-blocker exposure prior to sepsis is associated with reduced mortality, and whether the apparent reduction in mortality may be attributed to the mitigation of catecholamine excess is unclear.

Efficacy and Safety of Esmolol in Treatment of Patients with Septic Shock

SV of septic shock patients is increased following esmolol therapy, and although CO is also decreased with HR, tissue perfusion is not worse, and MAPSElat can be used to predict an increase in SV before es Molol use.

Association Between Premorbid Beta-Blocker Exposure and Sepsis Outcomes—The Beta-Blockers in European and Australian/American Septic Patients (BEAST) Study

Exposure to noncardioselective β-blocker before septic episode was associated with decreased mortality and Sequential Organ Failure Assessment score analysis showed that premorbid β- blocker exposure had potential benefits in reducing respiratory and neurologic dysfunction.

Continuing chronic beta-blockade in the acute phase of severe sepsis and septic shock is associated with decreased mortality rates up to 90 days

Continuing pre-existing chronic beta-blockade might be associated with decreased mortality rates up to 90 days in septic patients.



[Effects of the β-blockers on cardiac protection and hemodynamics in patients with septic shock: a prospective study].

β-blockers (esmolol) can improve cardiac function and myocardial injury in patients with sepsis shock and there were significant differences in HR, CI, SVRI, and GEDVI between treatment group and control group from 12 hours on.

Effect of beta blockers on sepsis outcome.

The authors did not show a significant association between beta blockers and increased mortality in patients with sepsis, and possibility that beta blocker use may have contributed to this risk cannot be completely ruled out.

Use of beta-blockers in non-cardiac surgery: an open debate.

All the evidence available must now be taken into consideration to develop more appropriate guidelines to minimise the risks and enhance the benefits of perioperative beta-blockade.

Diastolic dysfunction and mortality in septic patients: a systematic review and meta-analysis

Diastolic dysfunction is common in septic patients and it is associated with mortality in this group of patients, while Systolic Dysfunction is less common and is not associated withortality in thisgroup of patients.

Is early ventricular dysfunction or dilatation associated with lower mortality rate in adult severe sepsis and septic shock? A meta-analysis

This meta-analysis failed to find any evidence to support the view that the survivors from severe sepsis or septic shock had lower ejection fractions, however, non-indexed left ventricular dimensions were mildly increased in the survivor group but the indexed dimensions were similar between the groups.

Effect of heart rate control with esmolol on hemodynamic and clinical outcomes in patients with septic shock: a randomized clinical trial.

Targeted heart rates were achieved in all patients in the esmolol group compared with those in the control group and no clinically relevant differences between groups in other cardiopulmonary variables nor in rescue therapy requirements were found.

Previous prescription of &bgr;-blockers is associated with reduced mortality among patients hospitalized in intensive care units for sepsis*

Chronic prescription of &bgr;-blockers may confer a survival advantage to patients who subsequently develop sepsis with organ dysfunction and who are admitted to an intensive care unit, as suggested by basic science and narrative reviews.

Preadmission beta-blocker use and 30-day mortality among patients in intensive care: a cohort study

Preadmission beta-blocker use is associated with reduced mortality following ICU admission and the odds ratio (OR) of death as a measure of relative risk using conditional logistic regression and also did a propensity score-matched analysis.

Diastolic dysfunction and mortality in severe sepsis and septic shock.

Diastolic dysfunction is common and is a major predictor of mortality in severe sepsis and septic shock.