Beta-blockers may improve hemodynamic and metabolic parameters in critical illness, with evidence suggesting decreased burn healing time, reduced mortality in traumatic brain injury, and improved outcomes in cardiac arrest.
Do beta-blockers improve clinical, hemodynamic, and metabolic outcomes in critically ill patients?
This review highlights the emerging evidence that beta-blockers may safely mitigate the adverse effects of sustained catecholamine upregulation in various critical illnesses.
Catecholamine upregulation is a core pathophysiological feature in critical illness. Sustained catecholamine β-adrenergic induction produces adverse effects relevant to critical illness management. β-blockers (βB) have proposed roles in various critically ill disease states, including sepsis, trauma, burns, and cardiac arrest. Mounting evidence suggests βB improve hemodynamic and metabolic parameters culminating in decreased burn healing time, reduced mortality in traumatic brain injury, and improved neurologic outcomes following cardiac arrest. In sepsis, βB appear hemodynamically benign after acute resuscitation and may augment cardiac function. The emergence of ultra-rapid βB provides new territory for βB, and early data suggest significant improvements in mitigating atrial fibrillation in persistently tachycardic septic patients. This review summarizes the evidence regarding the pharmacotherapeutic role of βB on relevant pathophysiology and clinical outcomes in various types of critical illness.
Bruning et al. (Fri,) conducted a review in Critical Illness (Sepsis, Burns, Traumatic Brain Injury, Cardiac Arrest). Beta-blockers vs. Standard of care or no beta-blocker was evaluated. Beta-blockers may improve hemodynamic and metabolic parameters in critical illness, with evidence suggesting decreased burn healing time, reduced mortality in traumatic brain injury, and improved outcomes in cardiac arrest.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: