典型文献
Beta-blockers in septic shock: What is new?
文献摘要：
The use of beta(
β)-blockers during septic shock aimed at countering peripheral adrenergic stress may be justified by the early reduction in deleterious effects resulting from sympathetic overactivation, and could improve the prognosis of patients in septic shock. Animal studies have demonstrated either a maintenance or increase in cardiac output (CO) despite the decrease in heart rate (HR) associated with improved myocardial performance. The mechanism by which
β-blockers alter hemodynamics in septic shock is debated; however, preclinical and clinical data show that
β-blockers are safe when started at a low dose. Recent publications (2019-2021) on adrenergic
β1 receptor antagonists used in septic shock indicate that esmolol and landiolol should not be used in the early phase. While there is no optimal timing for their administration, a minimum of 12 h after the initiation of vasopressor therapy in stabilized euvolemic patients is a reasonable option. Patients should have a normal cardiac function, although a slight depression is compatible with landiolol use under hemodynamic monitoring. Slow titration in patients who remain tachycardic is preferable to rapid titration. When used to decrease HR, landiolol is also effective in reducing the incidence of new arrhythmias. Results of a well-performed and well-powered randomized controlled trial (RCT) demonstrating a positive effect on survival - or at least on hard surrogates such as the incidence/duration of organ failure - are pending.
文献关键词：
Septic shock;Adrenergic
β1 receptor antagonists
;Norepinephrine
中图分类号：
作者姓名：
Lescroart Mickael;Pequignot Benjamin;Kimmoun Antoine;Klein Thomas;Levy Bruno
作者机构：
Service de Médecine Intensive et Réanimation Brabois, CHRU Nancy, P?le Cardio-Médico-Chirurgical, University Hospital of Nancy-Brabois, Rue du Morvan, Vand?uvre-les-Nancy 54511, France;INSERM U1116, Faculté de Médecine, Vand?uvre-les-Nancy 54511, France;Université de Lorraine, Nancy 54000, France
文献出处：
引用格式：
[1]Lescroart Mickael;Pequignot Benjamin;Kimmoun Antoine;Klein Thomas;Levy Bruno-.Beta-blockers in septic shock: What is new?)[J].重症医学（英文）,2022(03):150-155
A类：
esmolol,landiolol,euvolemic,tachycardic,Adrenergic,antagonists
B类：
Beta,blockers,septic,shock,What,new,beta,during,aimed,countering,peripheral,adrenergic,stress,may,justified,by,early,reduction,deleterious,effects,resulting,from,sympathetic,overactivation,could,prognosis,patients,Animal,studies,have,demonstrated,either,maintenance,increase,cardiac,output,despite,decrease,heart,associated,improved,myocardial,performance,mechanism,which,alter,hemodynamics,debated,however,preclinical,data,show,that,are,safe,when,started,dose,Recent,publications,receptor,used,indicate,should,not,phase,While,there,optimal,timing,their,administration,minimum,after,initiation,vasopressor,therapy,stabilized,reasonable,option,Patients,normal,function,although,slight,depression,compatible,under,monitoring,Slow,titration,who,remain,preferable,rapid,When,also,effective,reducing,incidence,arrhythmias,Results,well,performed,powered,randomized,controlled,trial,RCT,demonstrating,positive,survival,least,hard,surrogates,such,duration,organ,failure,pending,Septic,Norepinephrine
AB值：
0.58633
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