October - 2012
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Previous prescription of B-blockers is associated with reduced mortality among patients hospitalized in intensive care units for sepsisAlejandro Macchia, Marilena Romero, Pablo Dino Comignani, Javier Mariani, Antonio D’Ettorre, Nadia Prini, Mariano Santopinto, and Gianni Tognoni Crit Care Med, 2012, 40:2768–2772 This page is only available to Crit-IQ subscribers. To view the rest of this review and gain access to our vast array of critical care teaching tools including podcasts, vodcasts, modules, exam preparation tools, teaching aids and much more, login here, or Become a Member to register |
October |
Previous Comments
| Discussed in our Journal Club today. The comments were; - interesting area, similar to statins, with high community use of drug, and question about continuing or introducing the drug - There is an Italian Trial underway using esmolol in sepsis shock to control heart rate. Aiming to enrol 100 patients, the primary outcome is heart rate. Unlikely to answer the questions. | |
| Neil Orford-15 Oct, 2012 12:37:10 PM | |
| We have traditionally used a combo of volume (blood or fluids) vasopressors and bAGONISTS in the management of septic shock. Rivers et al then made it explicit and emphasised on the need for early intevention (the golden hour which everyone knows about..nothing new!!) Now some "cowboys" are going to use bblockers. WOW!! Neil says there is a trail with esmolol. How do these guys get approval for such studies? I would love to see how their use of vasopressors "sky rockets" and how many events of adverse haemodynamic situations they encounter. Would they then halt their trials early if they ran into such strife? I wonder. This is so counterintuitive, suggesting that basic knowledge of physiologic principles is lacking. I am in awe of such researchers making bold to announce such madness ! | |
| shocked!!-28 Nov, 2012 12:14:49 AM | |
Comment
Could B-blockers be protective in sepsis? This retrospective study of 9465 patients admitted to ICU with sepsis reported a lower mortality rate in those on chronic B-blocker(17.7% 28-d mortality) compared to those without (22.1%), despite having a higher risk profile. Very much hypothesis...