Pilot Study: Echocardiographic and Hemodynamic Effects of Esmolol in Septic Shock Patients
Overview
- Phase
- Phase 2
- Intervention
- Esmolol
- Conditions
- Shock, Septic
- Sponsor
- Peking Union Medical College Hospital
- Enrollment
- 36
- Locations
- 1
- Primary Endpoint
- Echocardiographic assessment of heart function
- Last Updated
- 9 years ago
Overview
Brief Summary
After initial hemodynamic stabilization, 36 septic shock patients with heart rate > of 90 bpm and requiring norepinephrine to maintain mean arterial pressure (MAP) more than 65 mmHg will be randomised into two groups, esmolol group and control group. Patients allocated to esmolol group will receive a continuous esmolol infusion to maintain a lowering of heart rate of 10%. Norepinephrine will be titrated to achieve a MAP more than 65 mmHg. To investigate myocardial performance, the investigators will assess Tissue Doppler imaging by echocardiography and hemodynamic measures. Data will be obtained at baseline ,after esmolol infusion once achieved the predefined heart rate threshold and 72hours after esmolol infusion.
Detailed Description
primary outcome were determined according to our previous study of tissue doppler.
Investigators
Eligibility Criteria
Inclusion Criteria
- •septic shock
- •fluid optimization
- •with a cardiac index \> 3 l/min/m2
- •Heart Rate \>90 /min
Exclusion Criteria
- •Cardiogenic shock
- •Bradycardia
- •History of Severe Asthma
- •Indications against Esmolol
Arms & Interventions
Esmolol
After, at least six hours of hemodynamic optimization, patients with a hyperdynamic shock received a conventional management with a continuous infusion of Esmolol titrated to gain a 10% reduction in heart rate. This infusion is maintained for 72 hours.
Intervention: Esmolol
Outcomes
Primary Outcomes
Echocardiographic assessment of heart function
Time Frame: over a period of 72 hrs
peak systolic velocity measured at the mitral annulus decreased 30% compared with control group
Secondary Outcomes
- Effects on vasopressor requirement(over a period of 72 hrs)
- 90-day hospital mortality(90 days)