Efficacy of Metoprolol in Reducing Mortality in Patients with Septic Shock. Randomized Controlled Clinical Study

Background: Sepsis is one of the most common fatal diseases worldwide; in Mexico it represents 27.3% of intensive care unit admissions, with a mortality of 30.4%. The use of ?-blockers, including metoprolol, has been evaluated in different meta-analyses, demonstrating safety; however, it has been concluded that the lack of randomized studies is the limiting factor in identifying its efficacy. Aim Of The Study: To evaluate the efficacy of metoprolol in reducing mortality in patients with sepsis. Methods: Double-blind, randomized, controlled clinical study. Conducted in patients between 18 and 75 years old, admitted to the internal medicine service with a diagnosis of sepsis, managed with antibiotics in the first 6 hours of diagnosis. Eleven subjects were included in the metoprolol-treated group and ten in the placebo group; heart rate, mean arterial pressure, lactate, SOFA index and mortality were evaluated. MAT remained stable in both groups, HR decreased by 16 bpm, while in the placebo group it decreased by only 9 bpm (p=0.050). Lactate values and SOFA index also decreased in the intervention group, only the latter with values of p?0.05. Results And Conclusions: The use of metoprolol decreases heart rate without having a significant effect on mean arterial pressure. As a consequence, it is safe to administer it at the dose considered, and it is plausible that it may have a beneficial impact in reducing mortality in patients presenting with sepsis. The ?-blockers are a promising therapy that requires further prospective randomized studies confirming the reported findings.