Effects of Esmolol on hemodynamics and tissue oxygenation of the patients with septic shock and tachycardia / 中国综合临床

ABSTRACT

ObjectiveTo evaluate the effects of Esmolo on the hemodynamic and tissue oxygenation of the patients with septic shock and tachycardia.MethodsSeventy four septic shock patients with tachycardia were enrolled and randomized into Esmolo-treated group and control group after early goal-directed therapy (EGDT).The patients in Esmolo group were given intravenous Esmlol to decrease the heart rate to below 110 beats per minute.Hemodynamic data and tissue oxygenation parameters,such as Heart rate (HR),Mean Artery Pressure ( MAP),Central Venous Pressure ( CVP),Cardiae Index ( CI),Stroke Volume Index ( SVI),Systemic Vascular Resistance Index (SVRI),Lactate,Centrol Venous Oxygen Saturation (SCVO2 ) were recorded before and 2,3,4 hours after the Esmolol treatment.Results Heart rate of Esmolol group was reduced at all time points after treatment,The difference of that from the control group was significant ( H R [ 108 ± 16 ] beats/min vs.[ 132 ± 18 ] beats/min,[ 101 ± 14] beats/min vs.[ 135 ± 19 ] beats/min,[ 106 ± 21 ] beats/rin vs.[ 129 ± 14]beats/min,all P ＜ 0.01 ).Compared to the control group,Stroke Volume Index of Esmolol group was significantly increased at each time point ( SVI [32 ± 12] ml/m2 vs.[22 ±8] ml/m2,[34 ± 14] ml/m2 vs.[21 ±6] ml/m2,[37 ± 10] ml/m2vs.[23 ±9] ml/m2,all P ＜0.05).Lactate of Esmolol group was significantly decreased at the end of the 3rd,4th hour of Esmolol treatment ( lactate [ 1.6 ± 1.1 ] mmol/L vs.[ 2.7 ± 1.2 ]mmol/L,[ 1.3 ± 0.9 ] mmol/Lvs.[ 2.8 ± 1.4 ] mmol/L,both P ＜ 0.01.There were no significant differences in MAP,CI,SVRI,SCVO2 between the two groups at each time point ( all P ＞ 0.05 ).Conclusion Esmolol can reduce heart rate significantly,improve cardiac work and tissue perfusion in septic shock patients with tachycardia.It is a feasible and safe treatment for this kind of patients.