Discussion
acute myocardial infarction, death, Sepsis, reinfarction, hypotension, septic shock
ACUTE MYOCARDIAL INFARCTION, SEPSIS, SEPTIC SHOCK, CARDIOGENIC SHOCK, DISEASE, VENTRICULAR FIBRILLATION, CRITICAL ILLNESS, SEVERE SEPSIS, DISEASES
Given its negative inotropic effect, the application of Esmolol is still widely controversial as one treatment of SIC. This study showed that all SIC patients achieved the target HR after Esmolol, and there was no significant reduction in left ventricular contractility, and the indicators of GEF and dP/dtmx were increased, and the short-term mortality rate was reduced compared with those with uncontrolled HR.Whether the use of β-blockers in the treatment of SIC worsens hemodynamics remains controversial as well. A large multi-center study showed that early application of β-blockers during acute myocardial infarction reduced the risk of reinfarction and ventricular fibrillation, but increased the incidence of cardiogenic shock, especially at the first day after admission [Although there is no uniform definition of SIC at present, LVEF decline is often considered a diagnostic criterion [In the present study, it was also found that the dosage of norepinephrine was very high at baseline in both groups. As is showed in baseline demographic and clinical characteristics, such as SOFA score and APACHE II score, the patients had a higher degree of critical ills, which were associated with the high dose of norepinephrine at baseline. Our hospital is a tertiary A-level hospital, and is also the location of the provincial critical care medicine quality control center where the patients admitted to are in a high degree of critical illness. The patients admitted to the ICU always suffer from various critical diseases and most of them are whose disease had progressed after treatment in other wards of the hospital. Patients were already suffering from severe sepsis or septic shock when transferred to the ICU, which may have contributed to the high dosage of norepinephrine use at baseline. The dosage of norepinephrine in group E increased after Esmolol. However, norepinephrine dose also increased in group C at 48 h, and there was no significant difference compared with group E. In addition, Fig. A large international randomized controlled trial study showed that the use of β-blockers in the perioperative period, especially when combined with hypotension, could significantly increase the risk of death [It was found in a prospective cohort study that the use of Esmolol in patients with severe Sepsis could reduce the duration of mechanical ventilation [