Milrinone and Metoprolol Therapy in Septic Shock
Author Information
Author(s): Christian A Schmittinger, Martin W Dünser, Maria Haller, Hanno Ulmer, Günter Luckner, Christian Torgersen, Stefan Jochberger, Walter R Hasibeder
Primary Institution: Innsbruck Medical University
Hypothesis
Metoprolol would reduce heart rate without destabilizing cardiovascular function.
Conclusion
Low doses of enteral metoprolol in combination with phosphodiesterase inhibitors are feasible in patients with septic shock and cardiac depression but no overt heart failure.
Supporting Evidence
- Heart rate control was achieved in 97.5% of patients within 12.2 hours.
- Norepinephrine and milrinone dosages decreased significantly.
- pH levels increased while arterial lactate and serum C-reactive protein levels decreased.
- 28-day mortality was 33%.
Takeaway
Doctors used a medicine called metoprolol to help patients with a serious infection and heart problems. It helped slow their heart rates without making them worse.
Methodology
This was a retrospective analysis of 40 patients with septic shock and cardiac depression who received milrinone and enteral metoprolol therapy.
Potential Biases
Potential selection bias due to non-randomized treatment assignment.
Limitations
The study was retrospective, had a small sample size, and lacked strict protocol adherence.
Participant Demographics
Mean age was 71 years, with 53% male and various comorbidities including hypertension and coronary artery disease.
Statistical Information
P-Value
p<0.001
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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