title: Clinical role and efficacy of landiolol in the intensive care unit.
abstract: Beta-adrenergic receptor blockers have proved to be effective for the management of various cardiovascular diseases and the prevention of perioperative cardiac events and cerebrovascular accidents. Landiolol is a short-acting beta-blocker, with high beta 1-selectivity and a short duration of action. We thought landiolol was valuable and suitable for intensive care unit (ICU) patients, and conducted a retrospective study. The records of 80 patients (58 post-surgical patients; group S and 22 internal medicine patients; group IM) were reviewed. Thirty-seven (64%) of the group S patients were post-coronary artery bypass graft surgery, and the IM group consisted mostly of patients with acute myocardial infarction. The most common indication for landiolol in group S was the prevention of myocardial ischemia (50%), and in group IM, it was atrial fibrillation (45%). The median infusion rate of landiolol was 5 microg.kg(-1).min(-1) and the median infusion time was 2 days. Twenty-six patients were continued on oral beta-adrenergic receptor blockers. Landiolol reduced heart rate significantly without reducing blood pressure, and stabilized hemodynamics. We confirmed that landiolol is valuable as a bridge to starting oral beta-adrenergic receptor blockers and as an anti-arrhythmic agent, and that it is suitable for ICU patients due to its high beta 1-selectivity and rapid onset and offset of action.
authors.affiliation: Department of Anesthesiology, Nippon Medical School, Tokyo, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Terajima
authors.forename: Chiyo
authors.initials: C
authors.lastname: Sato
authors.forename: Shinji
authors.initials: S
authors.lastname: Akada
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Miyagi
authors.forename: Takashi
authors.initials: T
authors.lastname: Hongo
authors.forename: Shinhiro
authors.initials: S
authors.lastname: Takeda
authors.forename: Keiji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Sakamoto
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D001281:Atrial Fibrillation / Q000517:prevention & control*; D001794:Blood Pressure / Q000187:drug effects; D002395:Catecholamines / Q000502:physiology; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use*; D017202:Myocardial Ischemia / Q000517:prevention & control*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014508:Urea / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D002395:Catecholamines; D009025:Morpholines; C077049:landiolol; D014508:Urea