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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Esmolol | Experimental | 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. |
|
| Control | No Intervention | Patients received conventional management of septic shock |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Esmolol | Drug | conventional management plus esmolol infusion |
|
| Measure | Description | Time Frame |
|---|---|---|
| Echocardiographic assessment of heart function | peak systolic velocity measured at the mitral annulus decreased 30% compared with control group | over a period of 72 hrs |
| Measure | Description | Time Frame |
|---|---|---|
| Effects on vasopressor requirement | Dosage of norepinephrine increased 100% compared with control group | over a period of 72 hrs |
| 90-day hospital mortality | 90 days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yong-tai Liu, MD | Contact | +861069155068 | ataiever@163.com | |
| Li Weng, MD | Contact | +861069154035 | wengli@pumch.cn |
| Name | Affiliation | Role |
|---|---|---|
| Yong-tai Liu, MD | Peking Union Medical College Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking Union Medical College Hospital | Recruiting | Beijing | Beijing Municipality | 100730 | China |
There is not a plan to share individual participant data.
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| ID | Term |
|---|---|
| D012772 | Shock, Septic |
| D007022 | Hypotension |
| D018805 | Sepsis |
| D018746 | Systemic Inflammatory Response Syndrome |
| ID | Term |
|---|---|
| D007239 | Infections |
| D007249 | Inflammation |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| C036604 | esmolol |
| D000319 | Adrenergic beta-Antagonists |
| ID | Term |
|---|---|
| D018674 | Adrenergic Antagonists |
| D018663 | Adrenergic Agents |
| D018377 | Neurotransmitter Agents |
| D045504 | Molecular Mechanisms of Pharmacological Action |
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| D012769 | Shock |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
| D045505 | Physiological Effects of Drugs |