Evidence map›Paper›PMID 39841388›Full record

ArticleIntensive care medicine experimental2025

The effects of ultra-selective beta1-antagonism on the metabolic and cytokine profile in septic shock patients receiving noradrenaline: a sub-investigation from the STRESS-L Randomised Study.

Jarrod L Thomas, Kirsty C McGee, Anower Hossain, Gavin D Perkins, Anthony C Gordon, Duncan Young, Danny McAuley, Mervyn Singer, Ranjit Lall, Tina Kramaric and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Intensive care medicine experimental, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Efficacy of Landiolol for Treatment of Sepsis-Related Tachyarrhythmia: Lost in Translation.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Jarrod L ThomasInstitute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Kirsty C McGeeInstitute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Anower HossainWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
Gavin D PerkinsWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
Anthony C GordonDivision of Anaesthetics, Pain Medicine and Intensive Care, Faculty of Medicine, Imperial College London, London, UK.
Duncan YoungKadoorie Centre for Critical Care Research, Nuffield Division of Anaesthesia, University of Oxford, Oxford, UK.
Danny McAuleyRegional Intensive Care Unit, Royal Victoria Hospital, Belfast Health and Social Care Trust, Belfast, UK.
Mervyn SingerDepartment of Medicine and Wolfson Institute for Biomedical Research, Centre for Intensive Care Medicine, University College London, London, UK.
Ranjit LallWarwick Clinical Trials Unit, University of Warwick, Coventry, UK.
Tina KramaricDepartment of Life Sciences, Aberystwyth University, Ceredigion, UK.
Janet M LordInstitute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Tony WhitehouseInstitute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. tony.whitehouse@uhb.nhs.uk.ORCID http://orcid.org/0000-0002-4387-3421
Luis A J MurDepartment of Life Sciences, Aberystwyth University, Ceredigion, UK.
STRESS-L. collaborators

Funding

Efficacy and Mechanism Evaluation Programme 14/150/85
6 · The paper itself

Abstract

purposeThe landiolol and organ failure in patients with septic shock (STRESS-L study) included a pre-planned sub-study to assess the effect of landiolol treatment on inflammatory and metabolomic markers.

methodsSamples collected from 91 patients randomised to STRESS-L were profiled for immune and metabolomic markers. A panel of pro- and anti-inflammatory cytokines were measured through commercially acquired multiplex Luminex assays and statistically analysed by individual and cluster-level analysis (patient). Metabolite fingerprinting was carried out by flow infusion electrospray ionisation high-resolution mass spectrometry and metabolomic data were analysed using the R-based platform MetaboAnalyst. The metabolites were identified using DIMEdb (dimedb.ibers.aber.ac.uk) from their mass/charge ratios. These metabolomic data were also re-analysed using individual and cluster-level analysis. The individual-level models were adjusted for confounders, such as age, sex, noradrenaline dosage and patient (random effect).

resultsAnalysis was undertaken at cluster- and individual-level. There were no significant differences in cytokine concentration level between trial arms nor survivors and non-survivors over the duration of the observations from day 1 to day 4. Metabolomic analysis showed some separation in the levels of ceramides and cardiolipins between those who survived and those who died. Following adjusted analysis for confounders, plasma metabolite concentrations remained statistically different between landiolol and standard care arms for succinic acid, L-tryptophan, L-alanine, 2,2,2-trichloroethanol, lactic acid and D-glucose.

conclusionsIn a study of ICU patients with established septic shock and a tachycardia, landiolol treatment used to reduce the heart rate from above 95 to a range between 80 and 94 beats per minute did not induce significant cytokine changes. D-Glucose, lactic acid, succinic acid, L-alanine, L-tryptophan and trichloroethanol were pathways that may merit further investigation.

trial registrationEU Clinical Trials Register Eudra CT: 2017-001785-14 ( https://www.clinicaltrialsregister.eu/ctr-search/trial/2017-001785-14/GB ); ISRCTN registry Identifier: ISRCTN12600919 ( https://www.isrctn.com/ISRCTN12600919 ).

Indexed as

Clinical trialCytokinesMetabolomicsSepsisSeptic shockSTRESS-Lβ-Blocker

Identifiers

PMID39841388
PMCPMC11754546

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Registered trials

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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.