ReviewCritical care (London, England)2009
Bench-to-bedside review: Beta-adrenergic modulation in sepsis.
Review in Critical care (London, England), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
71 citing papers in PubMed, 3 syntheses or guidelines pooled it, 149 citations in OpenAlex.
- Evaluating the efficacy of esmolol in septic shock: a systematic review and meta-analysis.Systematic reviews · 2026Pooled it
- Beta-blocker treatment in the critically ill: a systematic review and meta-analysis.Annals of medicine · 2022Pooled it
- The association between premorbid beta blocker exposure and mortality in sepsis-a systematic review.Critical care (London, England) · 2019Pooled it
- Treatment with carvedilol improves survival of patients with acute-on-chronic liver failure: a randomized controlled trial.Hepatology international · 2019Trial
- Impact of Vasoactive Medications on ICU-Acquired Weakness in Mechanically Ventilated Patients.Chest · 2018Trial
- Cardiovascular adrenoceptors physiology in patients with shock.Intensive care medicine · 2026Article
- Risk and mediation analysis of early β-blocker use on survival outcomes in sepsis patients and new-onset atrial fibrillation: an analysis of the MIMIC-IV database.Journal of thoracic disease · 2026Article
- Current and future strategies aiming at reducing catecholamine exposure in septic shock.Critical care (London, England) · 2026Review
- The gut-lung axis in ARDS: beyond microbial translocation.Respiratory research · 2026Review
- Landiolol in perioperative and critical care: evidence, patient selection, and practical titration for targeted heart rate control: a narrative review.Journal of anesthesia, analgesia and critical care · 2026Review
- Article
- Norepinephrine exacerbates LPS-induced cardiomyopathy via SIRT3/HO-1 axis-mediated ferroptosis.Critical care (London, England) · 2025Article
- A comprehensive review on anti-inflammatory plants: a mechanistic insight through preclinical and clinical studies.Inflammopharmacology · 2025Review
- Acute Kidney Injury During Sepsis and Prognostic Role of Coexistent Chronic Heart Failure.Journal of clinical medicine · 2025Review
- Is the P-wave dispersion a valuable tool in determining the atrial arrhythmia of newborn babies with sepsis?Northern clinics of Istanbul · 2025Article
- Impact of premorbid use of beta‑blockers on survival outcomes of patients with sepsis: A systematic review and meta‑analysis.Experimental and therapeutic medicine · 2024Article
- Article
- Revolution in sepsis: a symptoms-based to a systems-based approach?Journal of biomedical science · 2024Review
- Current Perspectives of Mitochondria in Sepsis-Induced Cardiomyopathy.International journal of molecular sciences · 2024Review
- Ivabradine in Septic Shock: A Narrative Review.Journal of clinical medicine · 2024Review
11 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Sepsis, despite recent therapeutic progress, still carries unacceptably high mortality rates. The adrenergic system, a key modulator of organ function and cardiovascular homeostasis, could be an interesting new therapeutic target for septic shock. Beta-adrenergic regulation of the immune function in sepsis is complex and is time dependent. However, beta2 activation as well as beta1 blockade seems to downregulate proinflammatory response by modulating the cytokine production profile. beta1 blockade improves cardiovascular homeostasis in septic animals, by lowering myocardial oxygen consumption without altering organ perfusion, and perhaps by restoring normal cardiovascular variability. Beta-blockers could also be of interest in the systemic catabolic response to sepsis, as they oppose epinephrine which is known to promote hyperglycemia, lipid and protein catabolism. The role of beta-blockers in coagulation is less clear cut. They could have a favorable role in the septic pro-coagulant state, as beta1 blockade may reduce platelet aggregation and normalize the depressed fibrinolytic status induced by adrenergic stimulation. Therefore, beta1 blockade as well as beta2 activation improves sepsis-induced immune, cardiovascular and coagulation dysfunctions. Beta2 blocking, however, seems beneficial in the metabolic field. Enough evidence has been accumulated in the literature to propose beta-adrenergic modulation, beta1 blockade and beta2 activation in particular, as new promising therapeutic targets for septic dyshomeostasis, modulating favorably immune, cardiovascular, metabolic and coagulation systems.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.