Trial reportIntensive care medicine2024
Landiolol for heart rate control in patients with septic shock and persistent tachycardia. A multicenter randomized clinical trial (Landi-SEP).
Trial report in Intensive care medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 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
43 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Comparison of Esmolol Versus Landiolol on Mortality in Adult Patients With Sepsis: A Systematic Review and Network Meta-Analysis.Critical care medicine · 2026Pooled it
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Mortality in septic patients treated with short-acting betablockers: a comprehensive meta-analysis of randomized controlled trials.Critical care (London, England) · 2024Pooled it
- Pharmacokinetics of Landiolol and Its Metabolite M1 During Renal Replacement Therapy in Septic Shock Patients: A Sub-Study of the Landi-SEP Trial.European journal of drug metabolism and pharmacokinetics · 2026Trial
- Prognostic significance of heart rate trajectories on organ failure in predicted severe acute pancreatitis: secondary analysis of a randomized trial.Scientific reports · 2026Trial
- State-of-the-art review: ß-blockade in critical illness.Intensive care medicine · 2026Review
- Rate control in septic shock-associated atrial fibrillation: flow, not heart rate alone, should define haemodynamic success.Critical care (London, England) · 2026Article
- Use of landiolol in septic shock patients with new onset of atrial fibrillation: a European Delphi consensus.Critical care (London, England) · 2026Article
- Comparative efficacy of landiolol and bisoprolol transdermal patch in patients with sepsis-related tachycardia: a retrospective cohort study.Journal of intensive care · 2026Article
- Association of anti-catecholaminergic antiarrhythmic drugs with survival in sepsis-associated new-onset atrial fibrillation.Scientific reports · 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
- 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
- Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026.Intensive care medicine · 2026Article
- Impact of heart rate on Doppler echocardiography predictors of rhythm control in patients with septic shock.Scientific reports · 2026Article
- 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
- What If We Let It Fibrillate? New Perspective on Atrial Fibrillation in Sepsis.Current medical science · 2026Review
- A multicentre observational study on landiolol use, efficacy, and safety in European patients with supraventricular arrhythmia (Landi-UP).European heart journal. Acute cardiovascular care · 2026Observational
- Clinical practice in using corticosteroids and adjunctive sepsis therapies at the bedside among European ICUs: an ESICM-endorsed survey.Intensive care medicine experimental · 2026Article
- Survival outcomes, determinants, and hemodynamic trajectories with intravenous βFrontiers in pharmacology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
28 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeExcessive tachycardia in resuscitated septic shock patients can impair hemodynamics and worsen patient outcome. We investigated whether heart rate (HR) control can be achieved without increased vasopressor requirements using the titratable highly selective, ultra-short-acting β1-blocker landiolol.
methodsThis randomized, open-label, controlled trial was conducted at 20 sites in 7 European countries from 2018 to 2022 and investigated the efficacy and safety of landiolol in adult patients with septic shock and persistent tachycardia. Patients were randomly assigned to receive either landiolol along with standard treatment (n = 99) or standard treatment alone (n = 101). The combined primary endpoint was HR response (i.e., HR within the range of 80-94 beats per minute) and its maintenance without increasing vasopressor requirements during the first 24 h after treatment start. Key secondary endpoints were 28-day mortality and adverse events.
resultsOut of 196 included septic shock patients, 98 received standard treatment combined with landiolol and 98 standard treatment alone. A significantly larger proportion of patients met the combined primary endpoint in the landiolol group than in the control group (39.8% [39/98] vs. 23.5% [23/98]), with a between-group difference of 16.5% (95% confidence interval [CI]: 3.4-28.8%; p = 0.013). There were no statistically significant differences between study groups in tested secondary outcomes and adverse events.
conclusionThe ultra-short-acting beta-blocker landiolol was effective in reducing and maintaining HR without increasing vasopressor requirements after 24 h in patients with septic shock and persistent tachycardia. There were no differences in adverse events and clinical outcomes such as 28-day mortality vs. standard of care. The results of this study, in the context of previous trials, do not support a treatment strategy of stringent HR reduction (< 95 bpm) in an unselected septic shock population with persistent tachycardia. Further investigations are needed to identify septic shock patient phenotypes that benefit clinically from HR control.
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.