Table 1.
Characteristics of included studies in meta-analysis.
| Authors | Country | Study design | Age (yrs) (mean ± SD) |
Comparisons | No. of patients (male) |
Target HR (beats/min) |
APACHE II score (I/C) |
Outcomes |
|---|---|---|---|---|---|---|---|---|
| Morelli et al[28] | Italian | RCT | 66 ± 17.03 | Esmolol* | 77 (54) | 80-94 | NA | 28-day mortality, Lac, WBC |
| 69 ± 14.82 | Control† | 77 (53) | NA | length of ICU stay, PO2/FiO2 | ||||
| Yang et al[27] | China | RCT | 51.0 ± 22.6 | Esmolol‡ | 21 (NA) | <100 | 20.1 ± 9.2 | HR, ScvO2, MAP, CVP, Lac, |
| 55.0 ± 25.4 | Control† | 20 (NA) | 21.3 ± 8.3 | TnI, cardiac index, SVI | ||||
| Orbegozo Cortes et al[29] | Italian | RCT | 66 ± 17.03 | Esmolol* | 77 (54) | 80-94 | NA | 28-day mortality |
| 69 ± 14.82 | Control† | 77 (53) | NA | length of ICU stay | ||||
| Wang et al[25] | China | RCT | 34 ± 28.89 | Esmolol§ | 30 (19) | 75-94 | 21.2 ± 5.7 | 28-day mortality, HR, MAP, CVP, Lac |
| 38 ± 27.41 | Control‖ | 30 (19) | 20.8 ± 5.6 | TnI, cardiac index, SVI, TNF-α, IL-6, | ||||
| Liu et al[26] | China | RCT | 61.4 ± 6.9 | Esmolol¶ | 24 (NA) | <100 | 20.75 ± 3.05 | 28-day mortality, length of ICU stay, HR |
| 61.2 ± 6.4 | Control† | 24 (NA) | 21.21 ± 2.67 | ScvO2, MAP, CVP, Lac, Cardiac index, SVI | ||||
| Wang et al[24] | China | RCT | 67.2 ± 12.5 | Esmolol# | 30 (18) | <95 | 18.4 ± 6.3 | 28-day mortality, HR, MAP, Lac |
| 62.5 ± 14.5 | Control** | 30 (21) | 15.7 ± 6.3 | Cardiac index, SVI, TNF-α, IL-6, WBC | ||||
| Liu et al[23] | China | RCT | 58 ± 15 | Eesmolol†† | 50 (29) | 80-100 | 18.8 ± 6.5 | 28-day mortality, length of ICU stay |
| 57 ± 18 | Control† | 50 (28) | 19.1 ± 7.5 | HR, Lac, WBC | ||||
| Michael et al[19] | Israel | RCT | 62 ± 10.37 | Esmolol‡‡ | 18 (10) | 80-94 | NA | HR, length of ICU stay, Lac, TNF-α |
| 64 ± 8.89 | Control§§ | 22 (13) | IL-6 |
CVP = central venous pressure, HR = heart rate, IL-6 = interleukin 6, MAP = mean arterial pressure, ScvO2 = central venous oxygen saturation, SVI = stroke volume index; TNF-a = tumor necrosis factor-a, TnI = troponin I, WBC = white blood cell.
Continuous esmolol infusion commenced at 25 mg/h and progressively increased the rate at 20-minute intervals in increments of 50 mg/h, or more slowly at the discretion of the investigators, to reach the target heart rate between 80/min and 94/min within 12 hours.
Basic treatment.
Micropump with dosage of esmolol 0.05 mg/kg/min to control HR below 100/min within 2 hours.
Continuous intravenous infusion of esmolol, milrinone that commenced with a loading dosage of 30 μg/kg and was maintained at 0.375 to 0.5 μg/kg/min.
Continuous intravenous infusion of milrinone that commenced with a loading dosage of 30 μg/kg and was maintained at 0.375 to 0.5 μg/kg/min.
Micropump with dosage of esmolol 0.05 mg/kg/min to control HR below 100/min within 24 hours.
#Continuous intravenous esmolol infusion for 24 hours, initial dose was 0.05 mg/kg/h, to control HR below 95/min within 4 hours.
Isotonic saline was given to control group through intravenous line at 3 mL/h for 24 hours.
Continuous esmolol micropump commenced at 25 mg/h to maintain HR 80 to 100/min within 12 hours.
Continuous esmolol micropump commenced at 0.05 mg/kg/min to maintain HR 80 to 94/min for 24 hours.
Saline was given at the beginning of study interventions.