Esmolol Effects on Heart and Inflammation in Septic Shock

Anti-inflammatory and Cardiac Effects of Esmolol in Septic Shock. ESMOSEPSIS Study

Beta adrenergic system, over-activated in septic shock patients, is a key modulator of the inflammatory response. Experimental works demonstrated that Esmolol, an highly selective beta-1 blocker, reduces heart rate and regulates the inflammatory response. A recent mono centric, double blind, randomized clinical work in septic shock patients has shown that Esmolol administration is safe and reduces effectively heart rate. However there are only sparse data on 1) regional and micro-circulation, 2) inflammation modulation in human resuscitated septic shock patients treated by esmolol.

Inclusion Criteria:

• septic shock patients following the definition of the Surviving Sepsis Campaign
• femoral and central venous catheters for thermodilution monitoring
• fluid optimization
• with a cardiac index > 3 l/min/m2
• Heart Rate >100 /min

Exclusion Criteria:

• Cardiogenic shock
• Bradycardia
• History of Severe Asthma
• Indications against esmolol