Pr otective effect of esmol ol on myocardial injury in septic patei nts

doi:10.3969/j.issn.1002-1949.2015.08.002

Abstract：Objective To explore the protective effect of esmolol on myocardial injury in septic patients.Methods A prospective randomized controlled trial was conducted.Sixty two septic patients with myocardial injury, admitted to medical intensive care unit ( MICU) of Lanzhou University Second Hospital from January 2012 to January 2015, were randomly divided into control group( n=29) and treatment group ( n =33 ) .Patients in control group were given standard treatment of sepsis, while patients in treatment group accepted standard treatment plus esmolol injection in order to control the heart rate between 60 bpm and 100 bpm.All patients accepted continuous monitoring of heart rate (HR), mean arterial pressure ( MAP) , central venous pressure ( CVP) .Serum indexes, including lactic acid ( Lac) , central venous oxygen saturation ( ScvO2 ) , cTnT, BNP, tumor necrosis factor-α( TNF-α) and interleukin-1β( IL-1β); and the changes of LVEF, Sm and Ea/Aa were also observed in all patients by echocardiography at various time points ( 0 d, 1 d, 3d and 7 d of treatment ) .28 day mortality of the two groups was observed. Results Changes of all indexes were not significantly different between control group and treatment group ( P>0 .05)before treatment .Compared with control group, esmolol injection significantly decreased serum cTnT, BNP, TNF-α, IL-1βand HR, and elevated Ea/Aa ( P<0.05 ); but changes of MAP, LVEF, Sm, Lac, ScvO2 and28 day mortality were not significantly different between the two groups ( P >0.05 ).Conclusion Esmolol can improve myocardial injury of septic patients, probably through down-regulating the inflammatory responses.