AUTHOR=Huang Po , Zheng Xiangchun , Liu Zhi , Fang Xiaolei 

TITLE=The Efficacy and Safety of Esmolol for Septic Shock: A Systematic Review and Meta-analysis of Randomized Controlled Trials

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2021.682232

DOI=10.3389/fphar.2021.682232

ISSN=1663-9812

ABSTRACT=Purpose: The meta-analysis aims to identify whether septic shock patients can benefit from esmolol.
Materials and Methods: The relevant studies from MEDLINE, Cochrane Library, Embase were searched by two independent investigators using a variety of keywords. Stata software (version 12.0, Stata Corp LP, College Station, TX, USA)was used for statistical analysis. 
Results: A total of 14 studies were identified and incorporated into the meta-analysis. For overall analysis, the treatment of esmolol was associated with decreased 28-day mortality (RR=0.66, 95% CI=0.56-0.77, P＜0.001). Meanwhile, our analysis found that, esmolol could decrease HR (SMD: -1.70; 95% CI: [-2.24-(-1.17)], cTnI (SMD: -1.61; 95% CI: [-2.06-(-1.16)] compared with standard treatment. No significant differences between the two groups were found in MAP, Lac, CI and SVI.
Conclusions: For septic shock patients with tachycardia, when the heart rates meet 100≤HR≤120, clinicians could choose esmolol to control heart rates. Further high-quality and large-scale RCT should be performed to verify it and screening more suitable patients.