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Mortality in septic patients treated with short-acting betablockers: a comprehensive meta-analysis of randomized controlled trials.
Crit Care
November 2024
Department of Anaesthesiology, Intensive Care, Emergency Medicine, Transfusion Medicine and Pain Therapy, University Hospital of Bielefeld, Campus Bielefeld-Bethel, University of Bielefeld, Burgsteig 13, Haus Gilead I, 33617, Bielefeld, Germany.
Background: Treatment with short-acting betablockers in septic patients remains controversial. Two recent large multicenter trials have provided additional evidence on this therapeutic approach. We thus performed a meta-analysis, including the most recent data, to evaluate the potential impacts of treatment with short-acting betablockers on mortality in adult septic patients.
View Article and Find Full Text PDFDifferential Effects of Landiolol in Patients with Atrial Fibrillation and Atrial Tachycardia.
Medicina (Kaunas)
October 2024
Cardiovascular Center, Miyazaki Medical Association Hospital, Miyazaki 880-2102, Japan.
Landiolol, an ultra-short-acting β1-selective blocker, is more effective in controlling heart rate compared with digoxin in patients with atrial tachyarrhythmias and left ventricular dysfunction. However, the effect of atrial tachyarrhythmia type on the effectiveness of landiolol remains unknown. Hence, this study aimed to evaluate the effectiveness of landiolol in patients with atrial fibrillation (AF) and atrial tachycardia (AT), not limited to those with heart failure with a reduced ejection fraction.
View Article and Find Full Text PDFLandiolol in patients with septic shock.
Intensive Care Med
November 2024
Department of Critical Care, School of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Thessaly, Greece.
Landiolol for heart rate control in patients with septic shock and persistent tachycardia. A multicenter randomized clinical trial (Landi-SEP).
Intensive Care Med
October 2024
Department of Anaesthesia and Intensive Care, Charles University, 3rd Medical Faculty and University Hospital Královské Vinohrady, Prague, Czech Republic.
Article Synopsis
- Excessive heart rates in septic shock patients can negatively impact their health, prompting a study on the use of the ultra-short-acting beta-blocker landiolol to control heart rate without raising the need for vasopressors.
- Conducted across 20 sites in Europe from 2018 to 2022, the study compared landiolol combined with standard treatment to standard treatment alone in adults with septic shock and high heart rates, focusing on maintaining a target heart rate (80-94 bpm) without increasing vasopressor requirements.
- Results showed that a higher percentage of patients receiving landiolol achieved the target heart rate compared to those receiving standard treatment (39.8% vs. 23.5%), but there were no
Mortality in Patients With Sepsis Treated With Esmolol or Landiolol: A Systematic Review and Meta-Analysis of Randomized Controlled Trials With Trial Sequential Analysis.
Chest
August 2024
Department of Anaesthesia and Intensive Care, A.O.U. Policlinico-San Marco, Site "Policlinico G. Rodolico", Catania, Italy; Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
Background: The latest meta-analysis indicated potential survival benefits from ultra-short-acting β-blockers in patients with sepsis with persistent tachycardia. However, subsequent multicenter randomized controlled trials (RCTs) have reported conflicting findings, prompting the need for an updated meta-analysis to incorporate these newly published RCTs.
Research Question: Does the use of ultra-short-acting β-blockers (esmolol or landiolol) in patients with sepsis with persistent tachycardia improve mortality?
Study Design And Methods: We conducted an updated systematic search through April 2, 2024, exploring the MEDLINE, Cochrane Central Register of Controlled Trials, and Embase databases for RCTs reporting mortality in adult patients with sepsis treated with esmolol or landiolol as compared with those treated with neither of these or receiving placebo and published in English.
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