Application Evaluation of Esmolol Hydrochloride-Assisted Interventional Therapy on New-Onset Atrial Fibrillation in Patients with Severe Sepsis: A Retrospective Study
DOI:
https://doi.org/10.59958/hsf.7273Keywords:
esmolol hydrochloride, severe sepsis, new-onset atrial fibrillationAbstract
Objective: This study aims to explore the application effect of adjuvant therapy with esmolol hydrochloride on new-onset atrial fibrillation (NOAF) in patients with severe sepsis. Methods: Retrospective analysis was conducted on 170 patients with NOAF and severe sepsis admitted to our hospital from January 2022 to January 2023. After excluding eight patients who did not meet the inclusion criteria, the remaining 162 patients were included in the study. Based on different treatment methods, the patients were divided into the control group (n = 83, routine treatment) and the observation group (n = 79, esmolol hydrochloride in combination with routine treatment). The cardiac function indexes such as left atrial diameter, left ventricular end-diastolic dimension, left ventricular end-systolic dimension and left ventricular ejection fraction; left atrial wall tension-related indexes, including atrial natriuretic peptide, B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide; inflammatory factors, including a C-reactive protein, high-sensitivity C-reactive protein, interleukin-6 and procalcitonin and the incidence of adverse reactions were compared between the two groups. Statistical methods were used to process and compare the above-mentioned data and index results. Results: No significant difference was observed in cardiac function indexes, left atrial wall tension-related indexes and inflammatory factors in both groups before treatment (p > 0.05). After treatment, the observation group had lower cardiac function indexes, left atrial wall tension-related indexes and inflammatory factors than the control group (p < 0.05), and the incidence of adverse reactions in the two groups was similar (p < 0.05). Conclusion: The adjuvant therapy with esmolol hydrochloride has a certain clinical effect on patients with severe sepsis and NOAF, which improves the cardiac function of such patients and reduces their inflammation levels up to a point, showing a clinical application value.
References
Salomão R, Ferreira BL, Salomão MC, Santos SS, Azevedo LCP, Brunialti MKC. Sepsis: evolving concepts and challenges. Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas. 2019; 52: e8595.
Sweeney DA, Wiley BM. Integrated Multiorgan Bedside Ultrasound for the Diagnosis and Management of Sepsis and Septic Shock. Seminars in Respiratory and Critical Care Medicine. 2021; 42: 641–649.
Aibar J, Schulman S. New-Onset Atrial Fibrillation in Sepsis: A Narrative Review. Seminars in Thrombosis and Hemostasis. 2021; 47: 18–25.
Corica B, Romiti GF, Basili S, Proietti M. Prevalence of New-Onset Atrial Fibrillation and Associated Outcomes in Patients with Sepsis: A Systematic Review and Meta-Analysis. Journal of Personalized Medicine. 2022; 12: 547.
Bosch NA, Cohen DM, Walkey AJ. Risk Factors for New-Onset Atrial Fibrillation in Patients with Sepsis: A Systematic Review and Meta-Analysis. Critical Care Medicine. 2019; 47: 280–287.
Hasegawa D, Sato R, Prasitlumkum N, Nishida K, Takahashi K, Yatabe T, et al. Effect of Ultrashort-Acting β-Blockers on Mortality in Patients with Sepsis with Persistent Tachycardia Despite Initial Resuscitation: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Chest. 2021; 159: 2289–2300.
Lee J, Levy MM. Treatment of Patients with Severe Sepsis and Septic Shock: Current Evidence-Based Practices. Rhode Island Medical Journal (2013). 2019; 102: 18–21.
Kuttab HI, Lykins JD, Hughes MD, Wroblewski K, Keast EP, Kukoyi O, et al. Evaluation and Predictors of Fluid Resuscitation in Patients with Severe Sepsis and Septic Shock. Critical Care Medicine. 2019; 47: 1582–1590.
Huerta LE, Rice TW. Pathologic Difference between Sepsis and Bloodstream Infections. The Journal of Applied Laboratory Medicine. 2019; 3: 654–663.
Andriolo BN, Andriolo RB, Salomão R, Atallah ÁN. Effectiveness and safety of procalcitonin evaluation for reducing mortality in adults with sepsis, severe sepsis or septic shock. The Cochrane Database of Systematic Reviews. 2017; 1: CD010959.
Font MD, Thyagarajan B, Khanna AK. Sepsis and Septic Shock - Basics of diagnosis, pathophysiology and clinical decision making. The Medical Clinics of North America. 2020; 104: 573–585.
Piva S, Bertoni M, Gitti N, Rasulo FA, Latronico N. Neurological complications of sepsis. Current Opinion in Critical Care. 2023; 29: 75–84.
Bosch NA, Cimini J, Walkey AJ. Atrial Fibrillation in the ICU. Chest. 2018; 154: 1424–1434.
Bignami E, Guarnieri M, Franco A, Gerli C, De Luca M, Monaco F, et al. Esmolol before cardioplegia and as cardioplegia adjuvant reduces cardiac troponin release after cardiac surgery. A randomized trial. Perfusion. 2017; 32: 313–320.
Wang J, Gao X, He Z, Wang J, Xu G, Li T. Evaluating the effects of Esmolol on cardiac function in patients with Septic cardiomyopathy by Speck-tracking echocardiography-a randomized controlled trial. BMC Anesthesiology. 2023; 23: 51.
Cocchi MN, Dargin J, Chase M, Patel PV, Grossestreuer A, Balaji L, et al. Esmolol to Treat the Hemodynamic Effects of Septic Shock: A Randomized Controlled Trial. Shock (Augusta, Ga.). 2022; 57: 508–517.
