已入深夜,您辛苦了!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!祝你早点完成任务,早点休息,好梦!

Effect of Ultrashort-Acting Β-Blocker on the Mortality of Patients with Sepsis or Septic Shock: A Systematic Review and Trial Sequential Meta-Analysis of Randomized Controlled Trials

感染性休克 荟萃分析 随机对照试验 医学 败血症 重症监护医学 休克(循环) 内科学
作者
Po‐Yu Huang,Ting-Hui Liu,Jheng-Yan Wu,Ya‐Wen Tsai,Wan‐Hsuan Hsu,Min‐Hsiang Chuang,Hung-Jen Tang,Chih‐Cheng Lai
标识
DOI:10.2139/ssrn.4819264
摘要

Importance: Sepsis poses a significant global health burden, with high morbidity and mortality rates, despite advances in evidence-based management. Adrenergic responses, particularly tachycardia, play a role in sepsis-related complications. Ultrashort-acting β-blockers, such as esmolol and landiolol, have been evaluated in randomized controlled trials (RCTs) for their impact on sepsis outcomes, but conflicting results have been reported. Objective: This systematic review and meta-analysis aim to provide an updated perspective on the impact of ultrashort-acting β-blockers on the clinical outcomes of sepsis. Data Sources: A comprehensive search of PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and ClinicalTrials.gov was conducted from inception to January 12, 2024. Study Selection: RCTs investigating the clinical effects and safety of ultrashort-acting β-blockers in sepsis or septic shock were included. Out of 1034 initially identified records, 27 RCTs met the eligibility criteria. Data Extraction and Synthesis: Two investigators independently screened, extracted, and assessed the risk of bias in the included studies. Meta-analyses were performed using random-effects models, and trial sequential analysis (TSA) was conducted to evaluate the reliability of cumulative evidence. Main outcome and measures: The primary outcome was 28-day mortality rate. Results: A total of 2253 patients involved in 27 RCTs were included. Overall, ultrashort-acting β-blockers significantly reduced the 28-day mortality rate (31.6% versus 48.4%; risk ratio [RR] 0.66; 95% CI 0.56–0.78). TSA provided robust evidence for the 28-day and in-hospital mortality benefit. The survival benefit remains evident in subgroups of patients with septic tachycardia (RR, 0.66; 95% CI, 0.47–0.93), septic cardiomyopathy (RR, 0.61; 95% CI, 0.44–0.83), Chinese populations (RR, 0.64; 95% CI, 0.54–0.76), and those treated with esmolol (RR, 0.64; 95% CI, 0.56–0.73). For patients with septic shock, only those with tachycardia demonstrated a statistically significant difference in mortality rates (RR, 0.70; 95% CI, 0.55–0.88). Conclusions and relevance: Adjuvant ultrashort-acting β-blocker therapy demonstrated potential benefits in improving survival for patients with sepsis or septic shock. The findings support the consideration of β-blockers, particularly esmolol, as a valuable adjunctive treatment in sepsis, emphasizing the need for further research to confirm efficacy in diverse populations and optimize dosage regimen.Funding: None to declare. Declaration of Interest: None to declare.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Ethan完成签到 ,获得积分0
刚刚
稳重筝发布了新的文献求助10
2秒前
伽拉完成签到,获得积分10
5秒前
科研通AI2S应助zero1122采纳,获得10
5秒前
6秒前
伽拉发布了新的文献求助10
8秒前
量子星尘发布了新的文献求助10
12秒前
ly完成签到,获得积分10
13秒前
周多多完成签到,获得积分20
13秒前
15秒前
fa完成签到,获得积分10
15秒前
稳重筝完成签到,获得积分20
16秒前
20秒前
Rory完成签到 ,获得积分10
20秒前
lQ发布了新的文献求助10
20秒前
22秒前
CipherSage应助伽拉采纳,获得10
23秒前
zhangzhi发布了新的文献求助10
24秒前
Rondab应助钱邦国采纳,获得200
24秒前
芯之痕发布了新的文献求助10
26秒前
WJane完成签到,获得积分10
28秒前
菜青虫完成签到,获得积分10
30秒前
在水一方应助zty123采纳,获得10
30秒前
30秒前
eric888应助zhuant采纳,获得80
30秒前
聂先生完成签到,获得积分10
30秒前
哈哈哈哈发布了新的文献求助10
31秒前
zhangzhi完成签到,获得积分20
34秒前
haha发布了新的文献求助10
36秒前
Dong完成签到 ,获得积分10
45秒前
粗心的小蜜蜂完成签到,获得积分10
48秒前
li完成签到 ,获得积分10
49秒前
球球了发布了新的文献求助10
49秒前
孙孙应助芯之痕采纳,获得10
50秒前
59秒前
1分钟前
顽主完成签到,获得积分10
1分钟前
April_nd完成签到,获得积分10
1分钟前
彼岸花开发布了新的文献求助50
1分钟前
桃子完成签到 ,获得积分10
1分钟前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3976600
求助须知:如何正确求助?哪些是违规求助? 3520674
关于积分的说明 11204422
捐赠科研通 3257298
什么是DOI,文献DOI怎么找? 1798683
邀请新用户注册赠送积分活动 877842
科研通“疑难数据库(出版商)”最低求助积分说明 806595