This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Zemei Zhou
Chongqing General Hospital, University of Chinese Academy of Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2979-8872
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Sepsis affects millions of people each year, and brings substantial health and economic burden to the global. Esmolol may have the potential in the treatment of sepsis and septic shock in adults. However, current evidence remains controversial.
Methods
We systematically searched PubMed, EMBASE and the Cochrane Central Register of Controlled Trials from their inception to September 19, 2020 for randomized controlled trials (RCTs) evaluating the efficacy of esmolol in sepsis and septic shock in adults. A random-effects meta-analysis was performed to combine effect estimates. Two investigators independently screened articles, extracted data, and assessed the quality of included studies.
Results
Seven RCTs were included with a total of 463 patients with sepsis and/or septic shock. Overall, compared with standard treatment, esmolol significantly decreased 28-day mortality (risk ratio [RR] 0.68, 95% confidence interval [CI] 0.52 to 0.88), and heart rate (standardized mean difference [SMD] -1.83, 95% CI -2.95 to -0.70) and troponin I (TnI) level (SMD − 0.59, 95% CI -1.02 to -0.16) at 24 hours after treatment; no significant effect was found on the length of intensive care unit stay, mean arterial pressure, central venous pressure, central venous oxygen saturation, Stroke Volume Index, tumor necrosis factor-a, interleukin 6, White Blood Cells and PO2/FiO2.
Conclusions
Esmolol treatment may be safe and effective in decreasing 28-day mortality, controlling heart rate, and preventing myocardial damage, but no evidence of effect on lung injury in sepsis and septic shock after fluid resuscitation early. There were no significant adverse effects on tissue perfusion and oxygen utilization.
Keywords
esmolol, septic shock, sepsis, mortality, meta-analysis
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Zemei Zhou
Chongqing General Hospital, University of Chinese Academy of Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2979-8872
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 13 Jan, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Sepsis affects millions of people each year, and brings substantial health and economic burden to the global. Esmolol may have the potential in the treatment of sepsis and septic shock in adults. However, current evidence remains controversial.
Methods
We systematically searched PubMed, EMBASE and the Cochrane Central Register of Controlled Trials from their inception to September 19, 2020 for randomized controlled trials (RCTs) evaluating the efficacy of esmolol in sepsis and septic shock in adults. A random-effects meta-analysis was performed to combine effect estimates. Two investigators independently screened articles, extracted data, and assessed the quality of included studies.
Results
Seven RCTs were included with a total of 463 patients with sepsis and/or septic shock. Overall, compared with standard treatment, esmolol significantly decreased 28-day mortality (risk ratio [RR] 0.68, 95% confidence interval [CI] 0.52 to 0.88), and heart rate (standardized mean difference [SMD] -1.83, 95% CI -2.95 to -0.70) and troponin I (TnI) level (SMD − 0.59, 95% CI -1.02 to -0.16) at 24 hours after treatment; no significant effect was found on the length of intensive care unit stay, mean arterial pressure, central venous pressure, central venous oxygen saturation, Stroke Volume Index, tumor necrosis factor-a, interleukin 6, White Blood Cells and PO2/FiO2.
Conclusions
Esmolol treatment may be safe and effective in decreasing 28-day mortality, controlling heart rate, and preventing myocardial damage, but no evidence of effect on lung injury in sepsis and septic shock after fluid resuscitation early. There were no significant adverse effects on tissue perfusion and oxygen utilization.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
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Figure 7
Figure 8
Figure 9
Figure 10
Figure 11
Figure 12
Figure 13
Figure 14
Figure 15
Figure 16
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