OBJECTIVE: Recent growing evidence suggests that beta-blocker treatment could improve cardiovascular dynamics and possibly the outcome of @entity1 admitted to intensive care with severe @entity295 or @entity326 . DESIGN: Systematic review. DATA SOURCES: MEDLINE and EMBASE healthcare databases. REVIEW METHODS: To investigate this topic, we conducted a systematic review of the above databases up to 31 May 2015. Due to the clinical novelty of the subject, we also included non-randomized clinical studies. We focused on the impact of beta-blocker treatment on mortality, also investigating its effects on cardiovascular, immune and metabolic function. Evidence from experimental studies was reviewed as well. RESULTS: From the initial search we selected 10 relevant clinical studies. Five prospective studies (two randomized) assessed the hemodynamic effects of the @entity8652 -blocker @entity7368 . Heart rate decreased significantly in all, but the impact on other parameters differed. The imbalance between prospective studies' size (10 to 144 @entity1 ) and the differences in their design disfavor a meta-analysis. One retrospective study showed improved hemodynamics combining @entity1406 and @entity7604 in septic @entity1 , and another retrospective study found no association between beta-blocker administration and mortality. We also found three case series. Twenty-one experimental studies evaluated the hemodynamic, immune and/or metabolic effects of selective and/or non-selective beta-blockers in animal models of @entity295 ( @entity235 , @entity19 , @entity1707 , @entity35 , @entity742 ), yielding conflicting results. CONCLUSIONS: Whilst there is not enough prospective data to conduct a meta-analysis, the available clinical data are promising. We discuss the ability of beta blockade to modulate @entity295 -induced alterations at cardiovascular, metabolic, immunologic and coagulation levels.

Beta-blocker use in severe @entity295 and XXXX : a systematic review.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1707 :: ('9823', 'Species') :: ['pigs'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity742 :: ('9940', 'Species') :: ['sheep'] @entity35 :: ('10116', 'Species') :: ['rats'] @entity326 :: ('MESH:D012772', 'Disease') :: ['septic shock'] @entity235 :: ('9615', 'Species') :: ['dogs'] @entity8652 :: ('3779', 'Gene') :: ['beta1'] @entity19 :: ('10090', 'Species') :: ['mice'] @entity1406 :: ('MESH:D008790', 'Chemical') :: ['metoprolol'] @entity7368 :: ('MESH:C036604', 'Chemical') :: ['esmolol'] @entity7604 :: ('MESH:D020105', 'Chemical') :: ['milrinone']
@entity326 :: (MESH:D012772,Disease) :: ['septic shock']
