Key result
The administration of landiolol at 40 μg/kg/min prevented harmful hyperdynamic circulatory responses to bronchoscopic endotracheal suctioning in intubated ICU patients.
Why the study?
Does landiolol reduce hemodynamic responses to bronchoscopy-assisted suctioning in intubated ICU patients?
RCT (n=14)
Double-blind
Cross-over design
No
Does landiolol reduce hemodynamic responses to bronchoscopy-assisted suctioning in intubated ICU patients?
Landiolol at 40 μg/kg/min effectively prevents hyperdynamic circulatory responses to bronchoscopic endotracheal suctioning in intubated ICU patients without causing subsequent circulatory depression.
Supports landiolol to blunt suction-induced hemodynamic surges in ventilated ICU patients; extends short-acting beta-blockade evidence to procedural stress.
Landiolol is an ultra-short-acting β1-selective antagonist developed in Japan that was recently approved for the treatment of tachycardia in intensive care units (ICUs). This study investigated the protective effects of landiolol against the cardiovascular responses during bronchoscopic endotracheal suctioning. This study enrolled 15 patients requiring orotracheal intubation in an ICU. All of the patients required endotracheal suctioning using fiber bronchoscopy while sedated at a Ramsay Scale of 2-3. All subsequent suctioning procedures were assigned randomly to three groups using a cross-over design: saline as a placebo (group C) or 20 or 40 μg kg(-1) min(-1) landiolol, respectively (groups L20 and L40). The infusion was started 3 min before bronchoscopy and continued for 6 min. The central venous pressure (CVP) heart rate (HR) and arterial blood pressure (BP) were recorded. Fourteen patients completed the investigation, and 30 procedures (n = 10/group) were analyzed. The suctioning significantly increased the CVP, HR, and BP in groups C and L20, although the changes in BP were of shorter duration in group L20. No significant increase in the hemodynamic parameters was observed in group L40. The administration of landiolol 40 μg kg(-1) min(-1) prevented a harmful hyperdynamic circulatory response to bronchoscopic endotracheal suctioning, without obvious decreases in HR or BP after the intervention.
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Tochikubo et al. (2014) conducted an RCT in Intubated ICU patients requiring bronchoscopy-assisted suctioning (n=14). Landiolol vs. Saline (placebo) was evaluated on Hemodynamic responses (heart rate, blood pressure, central venous pressure) during endotracheal bronchoscopic suctioning (p=<0.05). The administration of landiolol at 40 μg/kg/min prevented harmful hyperdynamic circulatory responses to bronchoscopic endotracheal suctioning in intubated ICU patients.
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