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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Pharmacoepidemiology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1380175

Effect of Ultr ashor t-acting β-blocker s on 28-day mor tality in patients with Sepsis with Per sistent Tachycar dia despite Initial Resuscitation: A meta-analysis of r andomized contr olled tr ials and tr ial sequential analysis

Provisionally accepted
Po Huang Po Huang 1Fusheng Liu Fusheng Liu 2Xiao Hu Xiao Hu 2Bo Li Bo Li 3Xiaolong Xu Xiaolong Xu 3*Qingquan Liu Qingquan Liu 3*
  • 1 Department of Emergency, DongFang hospital affilitated to Beijing universtiy of Traditional Chinese medicine, Beijing, China
  • 2 Department of Emergency, Dongfang Hospital, Beijing, China
  • 3 Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, Beijing Municipality, China

The final, formatted version of the article will be published soon.

    The meta-analysis aims to identify whether patients with sepsis with persistent tachycardia despite initial resuscitation can benefit from ultrashort-acting β-blockers.The relevant studies from MEDLINE, Cochrane Library, Embase were searched by two independent investigators. RevMan Version 5.3 (The Cochrane Collaboration) was used for statistical analysis. Results: A total of ten studies were identified and incorporated into the meta-analysis. The results showed that the administration of ultrashort-Acting β-blockers (esmolol/landiolol) in patients with sepsis with persistent tachycardia despite initial resuscitation was significantly associated with a lower 28-day mortality (RR, 0.73; 95% CI, 0.57-0.93; P˂0.01). Subgroup analysis showed that the administration of esmolol in patients with sepsis was significantly associated with a lower 28-d mortality (RR, 0.68; 95% CI, 0.55-0.84; P˂0.001). While, there was no significant difference between the landiolol and control group (RR, 0.98; 95% CI, 0.41-2.34; P=0.96). No significant differences between the two groups were found in 90-day mortality, MAP, Lac, CI, and TnI at 24h after enrollment.The meta-analysis indicated that the use of esmolol in patients with persistent tachycardia, despite initial resuscitation, was linked to a notable reduction in 28-day mortality rates. Therefore, this study advocates for the consideration of esmolol in the treatment of sepsis in cases where tachycardia persists despite initial resuscitation.

    Keywords: Ultrashort-acting β-blockers, Mortality, Sepsis, Tachycardia, Meta-analysis

    Received: 19 Feb 2024; Accepted: 20 May 2024.

    Copyright: © 2024 Huang, Liu, Hu, Li, Xu and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xiaolong Xu, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, Beijing Municipality, China
    Qingquan Liu, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, Beijing Municipality, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.