title: [Beta-blockers in septic shock: a review].
abstract: In septic shock, high adrenergic stress is associated with cardiovascular and systemic adverse effects, which can negatively affect the results. Beta-adrenergic receptor block has been shown to be effective in controlling the disproportionate increase in heart rate, maintaining a favorable hemodynamic profile and apparently improving the efficiency of the cardiovascular system in order to maintain tissue perfusion. They have also been shown to modulate favorably catecholamine-induced immunosuppression and to decrease insulin resistance, protein catabolism, and proinflammatory cytokine expression associated with cardiovascular dysfunction. Selective beta-1 blockers appear to provide better results than non-selective blockers, even suggesting a positive impact on mortality. Future clinical trials are still needed to confirm these findings and define the scope of their benefits.
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Son LLatzer, Palma de Mallorca, Islas Baleares, España. Electronic address: velarolando@hotmail.com.
authors.forename: R S
authors.initials: RS
authors.lastname: Vela-Vásquez
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Son LLatzer, Palma de Mallorca, Islas Baleares, España.
authors.forename: I
authors.initials: I
authors.lastname: Grigorov-Tzenkov
authors.affiliation: Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Son LLatzer, Palma de Mallorca, Islas Baleares, España.
authors.forename: J L
authors.initials: JL
authors.lastname: Aguilar
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000097:blood; D004353:Drug Evaluation, Preclinical; D005544:Forecasting; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007333:Insulin Resistance; D009102:Multiple Organ Failure / Q000503:physiopathology / Q000517:prevention & control; D012772:Shock, Septic / Q000188:drug therapy* / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000503:physiopathology
chemical_list: D000319:Adrenergic beta-Antagonists; D016207:Cytokines
keywords: Adrenergic blockade; Beta-blockers; Bloqueadores beta; Bloqueo adrenérgico; Esmolol; Sepsis; Septic shock; Septicemia; Shock séptico