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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
36
conventional management plus esmolol infusion
Peking Union Medical College Hospital
Beijing, Beijing Municipality, China
RECRUITINGEchocardiographic assessment of heart function
peak systolic velocity measured at the mitral annulus decreased 30% compared with control group
Time frame: over a period of 72 hrs
Effects on vasopressor requirement
Dosage of norepinephrine increased 100% compared with control group
Time frame: over a period of 72 hrs
90-day hospital mortality
Time frame: 90 days
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