Effect of norepinephrine combined with esmolol on myocardial function and lactate clearance rate in patients with septic shock

  Objective  To investigate the effect of norepinephrine combined with esmolol on myocardial function and lactate clearance rate in patients with septic shock.

  Methods  Totally 100 septic shock patients were divided into control group (n=48) and observation group (n=52) according to the order of hospital admission. All the patients were treated with standard anti-infection and fluid resuscitation. The control group was treated with norepinephrine on this basis, while the observation group was treated with esmolol on the basis of the control group. The mechanical ventilation time, hospital stay in intensive care unit (ICU), recovery success rate within 6 hours, myocardial function, blood lactate concentration and lactate clearance rate, tissue perfusion, sequential organ failure estimation (SOFA) score, acute physiology and chronic health (APACHE Ⅱ) score were compared between the two groups.

  Results  The duration of mechanical ventilation and hospital stay in ICU in the observation group were significantly shorter than those in the control group, while the success rate of resuscitation within 6 hours and lactate clearance rate after 7 days of treatment were significantly higher than those in the control group (P < 0.05). Before treatment, there were no significant differences in B-type natriuretic peptide (BNP), troponin T (cTnT), creatine phosphate isoenzyme (CK-MB), urine volume, central venous oxygen saturation (ScvO₂), SOFA score and APACHE Ⅱ score between the two groups (P>0.05). After treatment, BNP, cTnT and CK-MB, SOFA score and APACHE II score in both groups decreased significantly (P < 0.05), and the above indexes in the observation group were significantly lower than those in the control group (P < 0.05), while urine volume and ScvO₂ were significantly higher than those before treatment (P < 0.05), and urine volume and ScvO₂ in the observation group were significantly higher than those in the control group (P < 0.05).

  Conclusion  Norepinephrine combined with esmolol can improve the curative effect of patients with septic shock, protect myocardial function, improve lactate clearance rate and reduce the degree of hypoxia in patients′ tissues.