Effects of Esmolol combined with Norepinephrine on cardiac function and prognosis in patients with septic shock
Objective:To investigate effects of Esmolol combined with Norepinephrine on cardiac function and prognosis in patients with septic shock.Methods:The clinical data of 74 patients with septic shock admitted to this hospital from December 2020 to January 2023 were retrospectively analyzed.According to different treatment options,they were divided into control group and study group,37 cases in each.Both groups were treated with routine anti-infection,anti-inflammation and fluid resuscitation.On this basis,the control group was treated with Norepinephrine bitartrate injection,while the study group was treated with Esmolol hydrochloride injection on the basis of that of the control group.The levels of hemodynamic indexes[heart rate,mean arterial pressure(MAP)],the severity of illness[acute physiology and chronic health evaluation II(APACHE II),sequential organ failure assessment(SOFA)]score,the cardiac function indexes[stroke index(SVI),cardiac index(CI)]levels,the myocardial injury markers[high-sensitivity troponin T(hs-cTnT),N-terminal pro-brain natriuretic peptide(NT-proBNP)]levels,the the serum inflammatory factors[high mobility group protein B1(HMGB1),interleukin-6(IL-6)]levels,the blood lactic acid level,the incidence of adverse reactions,and the 28-day survival rate were compared between the two groups before and after the treatment.Results:After the treatment,the heart rate,the APACHE II and SOFA scores,the serum hs-cTnT,NT-proBNP,HMGB1,IL-6 levels and the blood lactate levels in the study group were lower than those in the control group,the levels of SVI and CI were higher than those in the control group,and the differences were statistically significant(P 0.05).The 28-day survival rate of the study group was 78.39%(29/37),and the 28-day survival rate of the control group was 67.57%(25/37).After 6 hours of treatment,the MAP levels in both groups were higher than those before the treatment,but there was no statistically significant difference between the groups(P>0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).The 28-day survival rate of the study group was 78.39%(29/37),that of the control group was 67.57%(25/37),and the difference was not statistically significant(P>0.05).Conclusions:Esmolol combined with Norepinephrine in the treatment of the patients with septic shock can promote the recovery of heart rate,and does not affect the levels of blood pressure,and reduce the myocardial injury,improve the cardiac function,and reduce the serum inflammatory factors and blood lactic acid levels,thereby accelerating the remission of the disease.Moreover,it is superior to single Norepinephrine treatment.