ArticleCritical care (London, England)2021
Hemodynamic and anti-inflammatory effects of early esmolol use in hyperkinetic septic shock: a pilot study.
Article in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 25 papers.
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.
Anti-inflammatory and Cardiac Effects of Esmolol in Septic Shock. ESMOSEPSIS Study
Effects of Esmolol on Oxygenation Index by Controlling Heart Rate in Patients With Acute Respiratory Distress Syndrome
Who cites it
25 citing papers in PubMed, 42 citations in OpenAlex.
- Prognostic significance of heart rate trajectories on organ failure in predicted severe acute pancreatitis: secondary analysis of a randomized trial.Scientific reports · 2026Trial
- Evaluating the effects of Esmolol on cardiac function in patients with Septic cardiomyopathy by Speck-tracking echocardiography-a randomized controlled trial.BMC anesthesiology · 2023Trial
- State-of-the-art review: ß-blockade in critical illness.Intensive care medicine · 2026Review
- Use of landiolol in septic shock patients with new onset of atrial fibrillation: a European Delphi consensus.Critical care (London, England) · 2026Article
- Association of anti-catecholaminergic antiarrhythmic drugs with survival in sepsis-associated new-onset atrial fibrillation.Scientific reports · 2026Article
- Article
- Effects of early use of norepinephrine combined with esmolol on hemodynamic stability and 28-day mortality in patients with septic shock.BMC infectious diseases · 2026Article
- Survival outcomes, determinants, and hemodynamic trajectories with intravenous βFrontiers in pharmacology · 2026Article
- Review
- Septic Cardiomyopathy: Difficult Definition, Challenging Diagnosis, Unclear Treatment.Journal of clinical medicine · 2025Review
- Comparison of the efficacy and safety of Landiolol and Esmolol in critically ill patients: a propensity score-matched study.Annals of intensive care · 2025Article
- The pros and cons of beta-blockers in sepsis: Where do we stand in 2024?Journal of intensive medicine · 2025Article
- U-shaped prognostic value of left ventricular-arterial coupling in septic patients: a prospective study.European journal of medical research · 2024Article
- The concomitant use of ultra short beta-blockers with vasopressors and inotropes in critically ill patients with septic shock: A systematic review and meta-analysis of randomized controlled trials.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2024Article
- Esmolol's Role in Hemodynamic Management During Pheochromocytoma Surgery: A Comprehensive Review.Cureus · 2024Review
- Landiolol for Treatment of New-Onset Atrial Fibrillation in Critical Care: A Systematic Review.Journal of clinical medicine · 2024Review
- Article
- Effectiveness of β-blockers in improving 28-day mortality in septic shock: insights from subgroup analysis and retrospective observational study.Frontiers in cardiovascular medicine · 2024Article
- The Association Between Tachycardia and Mortality in Septic Shock Patients According to Serum Lactate Level: A Nationwide Multicenter Cohort Study.Journal of Korean medical science · 2023Article
- Cardiovascular Subphenotypes in ARDS: Diagnostic and Therapeutic Implications and Overlap with Other ARDS Subphenotypes.Journal of clinical medicine · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral studies have shown that heart rate control with selective beta-1 blockers in septic shock is safe. In these trials, esmolol was administered 24 h after onset of septic shock in patients who remained tachycardic. While an earlier use of beta-blockers might be beneficial, such use remains challenging due to the difficulty in distinguishing between compensatory and non-compensatory tachycardia. Therefore, the Esmosepsis study was designed to study the effects of esmolol aimed at reducing the heart rate by 20% after the initial resuscitation process in hyperkinetic septic shock patients on (1) cardiac index and (2) systemic and regional hemodynamics as well as inflammatory patterns.
methodsNine consecutive stabilized tachycardic hyperkinetic septic shock patients treated with norepinephrine for a minimum of 6 h were included. Esmolol was infused during 6 h in order to decrease the heart rate by 20%. The following data were recorded at hours H0 (before esmolol administration), H1-H6 (esmolol administration) and 1 h after esmolol cessation (H7): systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, central venous pressure, heart rate, PICCO transpulmonary thermodilution, sublingual and musculo-cutaneous microcirculation, indocyanine green clearance and echocardiographic parameters, diuresis, lactate, and arterial and venous blood gases.
resultsEsmolol was infused 9 (6.4-11.6) hours after norepinephrine introduction. Esmolol was ceased early in 3 out of 9 patients due to a marked increase in norepinephrine requirement associated with a picture of persistent cardiac failure at the lowest esmolol dose. For the global group, during esmolol infusion, norepinephrine infusion increased from 0.49 (0.34-0.83) to 0.78 (0.3-1.11) µg/min/kg. The use of esmolol was associated with a significant decrease in heart rate from 115 (110-125) to 100 (92-103) beats/min and a decrease in cardiac index from 4.2 (3.1-4.4) to 2.9 (2.5-3.7) l/min/m
conclusionIn the very early phase of septic shock, heart rate reduction using fast esmolol titration is associated with an increased risk of hypotension and decreased cardiac index despite maintained adequate tissue perfusion (NCT02068287).
Indexed as
Identifiers
What OpenQuestion holds
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.