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ESICM: In Septic Shock, Esmolol Tied to Reduced Heart Rate

Esmolol linked to reduction in heart rates to target levels compared with standard care

ESICM: In Septic Shock, Esmolol Tied to Reduced Heart Rate

WEDNESDAY, Oct. 9 (HealthDay News) -- For patients in septic shock, the use of esmolol is linked to reductions in heart rates to target levels compared to the use of standard care, according to a study published online Oct. 9 in the Journal of the American Medical Association to coincide with presentation at the annual meeting of the European Society of Intensive Care Medicine, held from Oct. 5 to 9 in Paris.

Andrea Morelli, M.D., from the University of Rome, and colleagues conducted a randomized phase 2 trial to examine the effect of esmolol in patients with severe septic shock. Seventy-seven patients were randomized to continuous infusion of esmolol to maintain heart rate between 80/minute and 94/minute, and 77 were assigned to standard care.

The researchers found that targeted heart rates were achieved in all patients in the esmolol group. During the first 96 hours, the median area under the curve for heart rate was −28/minute for the esmolol group versus −6/minute for the control group (mean reduction, 18/minute; P < 0.001). There was a reduction in fluid requirements in the esmolol group. There were no clinically relevant differences noted in cardiopulmonary variables nor in rescue therapy use between the groups.

"For patients in septic shock, the open-label use of esmolol was able to achieve reductions in heart rate to target levels, without an increase in adverse outcomes compared with standard treatment," the authors write.

Two authors disclosed financial ties to Baxter, the manufacturer of esmolol.

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