Pilot Study: Echocardiographic and Hemodynamic Effects of Esmolol in Septic Shock Patients

Pilot Study: Echocardiographic and Hemodynamic Effects of Esmolol in Septic Shock Patients

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.

primary outcome were determined according to our previous study of tissue doppler.

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