Evidence map›Paper›PMID 33434497›Full record

SynthesisChest2021

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 Trials.

Daisuke Hasegawa, Ryota Sato, Narut Prasitlumkum, Kazuki Nishida, Kunihiko Takahashi, Tomoaki Yatabe, Osamu Nishida

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Chest, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05694585 (Effect of Continuous Infusion of Esmolol on Perioperative Stress Reaction in Patients Undergoing Airway Intervention), which is not on this map. Cited by 57 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT05694585 phase4unknown statusnot on this mapstarted 2023, after this paper: background citation

Effect of Continuous Infusion of Esmolol on Perioperative Stress Reaction in Patients Undergoing Airway Intervention

TypeinterventionalSponsorXiumei SongRan2023 to 2023Enrolled46ConditionsEsmolol, Stress Reaction, Airway Obstruction, CatecholamineArmsEsmolol, saline
3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  10. The poikilothermic hypothesis of sepsis.Critical care (London, England) · 2026
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Daisuke HasegawaDepartment of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Aichi, Japan.
Ryota SatoDepartment of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
Narut PrasitlumkumDepartment of Cardiology, University of California Riverside School of Medicine, CA.
Kazuki NishidaDepartment of Biostatistics Section, Center for Advanced Medicine and Clinical Research, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Kunihiko TakahashiDepartment of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan.
Tomoaki YatabeDepartment of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Aichi, Japan.
Osamu NishidaDepartment of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Aichi, Japan. Electronic address: nishida@fujita-hu.ac.jp.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHistorically, β-blockers have been considered to be relatively contraindicated for septic shock because they may cause cardiac suppression. On the other hand, there is an increasing interest in the use of β-blockers for treating patients with sepsis with persistent tachycardia despite initial resuscitation. RESEARCH QUESTION: Do ultrashort-acting β-blockers such as esmolol and landiolol improve mortality in patients with sepsis with persistent tachycardia despite initial resuscitation? STUDY DESIGN AND

methodsThis was a systematic review and meta-analysis. We searched MEDLINE, Cochrane Central Register of Controlled Trials, and Embase for randomized controlled trials (RCTs) that compared the mortality of patients with sepsis and septic shock treated with esmolol or landiolol. We updated our search on April 20, 2020. Two independent reviewers assessed whether titles and abstracts met the following eligibility criteria: (1) RCT, (2) patients with sepsis and septic shock ≥ 18 years of age, and (3) treatment with either esmolol/landiolol or placebo/no interventions. Two authors independently extracted selected patient and study characteristics and outcomes. The results of all analyses are presented using random effect models.

resultsSeven RCTs with a pooled sample size of 613 patients were included. Of these, six RCTs with 572 patients reported 28-day mortality. Esmolol or landiolol use in patients with sepsis and septic shock was significantly associated with lower 28-day mortality (risk ratio, 0.68; 95% CI, 0.54-0.85; P < .001). Unimportant heterogeneity was observed (I

interpretationThe 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. TRIAL REGISTRY: UMIN Clinical Trials Registry; No.: UMIN000040174; URL: https://www.umin.ac.jp/ctr/index.htm.

Indexed as

Randomized Controlled Trials as TopicAdrenergic beta-AntagonistsHumansResuscitationSepsisTachycardiaAdrenergic beta-Antagonistsesmolollandiololsepsissepsis-associated tachycardiaβ-blocker

Identifiers

PMID33434497

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.