β-Blockers in sepsis: Reexamining the evidence

Nathan M. Novotny, Tim Lahm, Troy A. Markel, Paul R. Crisostomo, Meijing Wang, Yue Wang, Rinki Ray, Jiangning Tan, Dalia Al-Azzawi, Daniel R. Meldrum

Research output: Contribution to journalReview article

51 Scopus citations

Abstract

Sepsis remains the leading cause for noncardiac intensive care unit deaths in the United States. Despite recent advances in the treatment of this devastating condition, mortality and morbidity remain unacceptably high. Sepsis is characterized by a multitude of pathophysiological changes that include inflammation, metabolic derangements, hemodynamic alterations, and multiorgan dysfunction. Unfortunately, several studies of treatment modalities aimed at correcting one or more of the underlying derangements have led to disappointing results. New treatment modalities are needed. β-Receptor blockers have long been used for a variety of conditions such as coronary artery disease, congestive heart failure, and arterial hypertension. Recent data suggest that β-blocker effects on metabolism, glucose homeostasis, cytokine expression, and myocardial function may be beneficial in the setting of sepsis. Although treating a potentially hypotensive condition with a drug with antihypertensive properties may initially seem counterintuitive, the metabolic and immunomodulatory properties of β-blockers may be of benefit. It is the purpose of this review to discuss the effects of β- blockers on the following: (1) metabolism, (2) glucose regulation, (3) the inflammatory response, (4) cardiac function, and (5) mortality in sepsis.

Original languageEnglish (US)
Pages (from-to)113-119
Number of pages7
JournalShock
Volume31
Issue number2
DOIs
StatePublished - Feb 1 2009

    Fingerprint

Keywords

  • β-adrenergic receptor
  • Cytokines
  • Endotoxin
  • Esmolol
  • LPS
  • Propranolol
  • Shock

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Emergency Medicine

Cite this

Novotny, N. M., Lahm, T., Markel, T. A., Crisostomo, P. R., Wang, M., Wang, Y., Ray, R., Tan, J., Al-Azzawi, D., & Meldrum, D. R. (2009). β-Blockers in sepsis: Reexamining the evidence. Shock, 31(2), 113-119. https://doi.org/10.1097/SHK.0b013e318180ffb6