Carrara Marta, Niccolo Arianna, Herpain Antoine, Ferrario Manuela
Annu Int Conf IEEE Eng Med Biol Soc. 2020 Jul;2020:382-385. doi: 10.1109/EMBC44109.2020.9176309.
An elevated heart rate (HR) often persists in resuscitated septic shock patients, increasing the risk of mortality. Several drugs for HR control, such as esmolol and ivabradine, have been tested in the recent years, but their benefit on the overall cardiovascular system is still under investigation. The aim of this study is to investigate the hemodynamic effects of the two drugs in a protocol of polymicrobial septic shock and resuscitation, mainly focusing on the vascular function. Twelve pigs were divided into three experimental groups: the esmolol-treated group (n=4), the ivabradine-treated group (n=5) and the control group (n=3). The characteristic arterial time constant τ was computed on aortic arterial pressure (AoP), together with estimates of total arterial compliance and peripheral resistance. Power spectral analysis of aortic and radial diastolic BP oscillations was performed to estimate the sympathetic autonomic control of vascular tone. Septic shock induced a severe cardiac and vascular disarray, only partially resolved by resuscitation. The administration of esmolol, but not ivabradine, was beneficial both for cardiac and vascular function, thereby its adjunction to standard therapies could help to improve patient's condition and optimize the resuscitation strategies.Clinical Relevance-This study shows a potential beneficial effect of esmolol on the arterial tree.
复苏后的感染性休克患者常持续存在心率（HR）升高的情况，这增加了死亡风险。近年来，已经对几种控制心率的药物，如艾司洛尔和伊伐布雷定进行了测试，但它们对整个心血管系统的益处仍在研究中。本研究的目的是在多微生物感染性休克及复苏方案中研究这两种药物的血流动力学效应，主要关注血管功能。将12头猪分为三个实验组：艾司洛尔治疗组（n = 4）、伊伐布雷定治疗组（n = 5）和对照组（n = 3）。根据主动脉血压（AoP）计算特征动脉时间常数τ，并估计总动脉顺应性和外周阻力。对主动脉和桡动脉舒张压振荡进行功率谱分析，以估计交感神经对血管张力的自主控制。感染性休克导致严重的心功能和血管功能紊乱，复苏仅部分缓解。艾司洛尔的给药对心脏和血管功能均有益，而伊伐布雷定则不然，因此将其添加到标准治疗中可能有助于改善患者状况并优化复苏策略。临床意义——本研究显示了艾司洛尔对动脉系统的潜在有益作用。
