Evaluating the effects of Esmolol on cardiac function in patients with Septic cardiomyopathy by Speck-tracking echocardiography—a randomized controlled trial

BMC Anesthesiology

Research Article

Junyi Wang¹  Xinjing Gao²  Zhengzhong He²  Tong Li²  Jinxiang Wang³  Guowu Xu³ 

[1] The Third Central Clinical College of Tianjin Medical University, 300170, Tianjin, China;The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, 300170, Tianjin, China;Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin, China;Tianjin Institute of Hepatobiliary Disease, Tianjin, China;The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, 300170, Tianjin, China;Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin, China;Tianjin Institute of Hepatobiliary Disease, Tianjin, China;Wenzhou Safety (Emergency) Institute of Tianjin University, Wenzhou 325026, Zhejiang, People’s Republic of China;Department of Emergency Medicine, Tianjin Medical University General Hospital, 300052, Tianjin, People’s Republic of China;

关键词: Sepsis;    Septic Shock;    Sepsis Induced Cardiomyopathy;    Speckle-tracking Echocardiography;   

DOI  :  10.1186/s12871-023-01983-8

 received in 2022-07-12, accepted in 2023-01-10,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundEsmolol as one treatment of sepsis induced cardiomyopathy (SIC) is still controversial. The objective of this study is to evaluate cardiac function after reducing heart rate by Esmolol in patients with SIC using speck-tracking echocardiography.MethodsThis study was a single-center, prospective, and randomized controlled study. A total of 100 SIC patients with a heart rate more than 100/min, admitted to the Intensive Care Department of Tianjin Third Central Hospital from March 1, 2020 to September 30, 2021, were selected as the research subjects. They were randomly divided into the Esmolol group (Group E) and the conventional treatment group (Group C), each with 50 cases. The target heart rate of patients in Group E was controlled between 80/min and 100/min. Speck-tracking echocardiography (STE) and pulse indicating continuous cardiac output monitoring (PICCO) were performed in both groups at 1 h, 24 h, 48 h, 72 h, 96 h and 7 d after admission, with data concerning left ventricular global longitudinal strain (GLS), left ventricular ejection fraction (LVEF) and global ejection fraction (GEF), left ventricular systolic force index (dP/dtmx) were obtained, respectively. Hemodynamics and other safety indicators were monitored throughout the whole process. These subjects were followed up to 90 d, with their mortality recorded at Day 28 and Day 90, respectively. Statistical analyses were performed using SPSS version 21.ResultsWith 24 h of Esmolol, all patients in Group E achieved the target heart rate, and there was no deterioration of GLS, or adverse events. However, compared with those in Group C, their GLS, GEF and dP/dtmx were increased, and the difference was statistically significant (P > 0.05). Compared with patients in Group C, those in Group E had lower short-term mortality, and logistic regression analysis also suggested that Esmolol improved patient outcomes.Conclusion In SIC patients, the application of Esmolol to lower heart rate decreased their short-term mortality while not making any impairment on the myocardial contractility.Trial registrationChinese Clinical Trial Registry, ChiCTR2100047513. Registered June 20, 2021- Retrospectively registered, http://www.chictr.org.cn/index.aspx. The study protocol followed the CONSORT guidelines. The study protocol was performed in the relevant guidelines.

【 授权许可】

CC BY   
© The Author(s) 2023

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