ReviewJournal of intensive medicine2022
Beta-blockers in septic shock: What is new?
Review in Journal of intensive medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 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
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Mortality in septic patients treated with short-acting betablockers: a comprehensive meta-analysis of randomized controlled trials.Critical care (London, England) · 2024Pooled it
- Association of beta blockers and mortality in adults with septic shock: systematic review and meta-analysis of randomized clinical trial.Frontiers in medicine · 2024Pooled it
- Beta blockers in traumatic brain injury: a systematic review and meta-analysis.Trauma surgery & acute care open · 2023Pooled it
- Landiolol for heart rate control in patients with septic shock and persistent tachycardia. A multicenter randomized clinical trial (Landi-SEP).Intensive care medicine · 2024Trial
- Stopping or continuing chronic antihypertensive therapy during hospitalization.Journal of internal medicine · 2026Article
- Nebivolol as a potential adjunct therapy for sepsis-induced cardiac dysfunction: evidence from a rat model.Scientific reports · 2026Article
- 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
- Non-selective beta-blockers enhance resolution of induced infections in animals and healthcare-associated infections in humans.Scientific reports · 2025Article
- Targeting sepsis through inflammation and oxidative metabolism.World journal of critical care medicine · 2025Review
- Acute Kidney Injury During Sepsis and Prognostic Role of Coexistent Chronic Heart Failure.Journal of clinical medicine · 2025Review
- The Clinical Utility of Targeted Heart Rate Control in Septic Shock: A Systematic Review and Meta-analysis of Randomized Controlled Trials with Trial Sequential Analysis.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Lymphopenia in sepsis: a narrative review.Critical care (London, England) · 2024Review
- Catecholamine treatment induces reversible heart injury and cardiomyocyte gene expression.Intensive care medicine experimental · 2024Article
- An Overview of the Pharmacokinetics and Pharmacodynamics of Landiolol (an Ultra-Short Acting β1 Selective Antagonist) in Atrial Fibrillation.Pharmaceutics · 2024Review
- Comparison of the Protective Effects of Nebivolol and Metoprolol against LPS-Induced Injury in H9c2 Cardiomyoblasts.Current issues in molecular biology · 2023Article
- Ventriculo-arterial (un)coupling in septic shock: Impact of current and upcoming hemodynamic drugs.Frontiers in cardiovascular 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
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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.
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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.