Landiolol and Organ Failure in Patients With Septic Shock
Why the study?
Beta-blockade may attenuate adrenergic stress from catecholamine exposure in septic shock, but the efficacy and safety of landiolol in patients with tachycardia and established septic shock requiring prolonged vasopressor support remained unclear.
Does landiolol infusion reduce organ failure measured by the SOFA score in adults with tachycardia and established septic shock requiring prolonged vasopressor support?
Population
126 adults with tachycardia and established septic shock requiring norepinephrine for at least 24 hours
Comparison
Landiolol infusion vs standard care
Design
Open-label, multicenter, randomized trial
Follow-up
90 days
Authors
Discussion
Loading...
Member takes
Implication
Landiolol did not reduce organ failure in septic shock tachycardia; challenges observational signals and does not support routine use.
Structured PICO
Does landiolol infusion reduce organ failure measured by the SOFA score in adults with tachycardia and established septic shock requiring prolonged vasopressor support?
P
Population
126 adults (≥18 years) with tachycardia (heart rate ≥95/min) and established septic shock treated for at least 24 hours with continuous norepinephrine (≥0.1 μg/kg/min), mean age 55.6 years, 58.7% male, in 40 UK National Health Service intensive care units.
I
Intervention
Landiolol infusion
C
Comparator
Standard care
O
Outcome
Mean Sequential Organ Failure Assessment (SOFA) score from randomization through 14 dayssurrogate
In patients with septic shock and tachycardia, landiolol infusion did not reduce organ failure and was associated with a signal of possible harm, leading to early trial termination.
Limitations
- Trial stopped prematurely due to a signal of possible harm
- Underpowered due to early termination (enrolled 126 of planned 340 participants)
- Open-label design
Cite This Study
Whitehouse et al. (2023) studied this question.