Evidence map›Paper›PMID 37872608›Full record

ArticleJournal of anesthesia, analgesia and critical care2023

The role of beta-blocker drugs in critically ill patients: a SIAARTI expert consensus statement.

Fabio Guarracino, Andrea Cortegiani, Massimo Antonelli, Astrid Behr, Giandomenico Biancofiore, Alfredo Del Gaudio, Francesco Forfori, Nicola Galdieri, Giacomo Grasselli, Gianluca Paternoster and 6 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of anesthesia, analgesia and critical care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 12 institutions in 2 countries.

Fabio GuarracinoCardiothoracic and Vascular Anesthesia and Intensive Care, Anesthesia and Resuscitation Department, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Andrea CortegianiDepartment of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy. andrea.cortegiani@unipa.it.ORCID http://orcid.org/0000-0003-1416-9993
Massimo AntonelliDepartment of Emergency, Anesthesiological and Resuscitation Sciences, Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Astrid BehrOperative Unit of Anesthesia and Resuscitation, Hospital of Camposampiero, Padua, Italy.
Giandomenico BiancofioreAnesthesia and Resuscitation Transplants, Department of Medical Pathology Surgical, Molecular and Critical Area, University of Pisa, Pisa, Italy.
Alfredo Del GaudioEmergency Department, Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy.
Francesco ForforiAnesthesia and Intensive Care, Anesthesia and Resuscitation Department, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Nicola GaldieriGeneral Cardiac Surgery Unit, Critical Area Department, Ospedale Dei Colli, Naples, Italy.
Giacomo GrasselliDepartment of Anesthesia, Resuscitation and Emergency, IRCCS Ca' Granda Foundation, Ospedale Maggiore Policlinico, Milan, Italy.
Gianluca PaternosterCardiovascular Anesthesia and ICU, San Carlo Hospital, Potenza, Italy.
Monica RoccoDepartment of Surgical and Medical Science and Translational Medicine, Sapienza University of Rome, Rome, Italy.
Stefano RomagnoliAnesthesia and Intensive Care Section, Department of Health Sciences, University of Florence, Florence, Italy.
Salvatore SardoDepartment of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Sascha TreskatschDepartment of Anesthesiology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Freie Universität and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
Vincenzo Francesco TripodiAnesthesia and Intensive Care Unit, Department of Surgery, University Hospital "Gaetano Martino", Messina, Italy.
Luigi TritapepeAnesthesia and Resuscitation Unit, San Camillo-Forlanini Hospital, Sapienza University, Rome, Italy.
Azienda Ospedaliera Universitaria Pisana · ITAgostino Gemelli University Polyclinic · ITAzienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" di Palermo · ITAzienda Ospedaliero-Universitaria Careggi · ITCarlo Forlanini Hospital · ITCasa Sollievo della Sofferenza · ITHumboldt-Universität zu Berlin · DEOspedale San Carlo · ITSapienza University of Rome · ITUniversity of Cagliari · ITUniversity of Milan · ITUniversity of Pisa · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe role of β-blockers in the critically ill has been studied, and data on the protective effects of these drugs on critically ill patients have been repeatedly reported in the literature over the last two decades. However, consensus and guidelines by scientific societies on the use of β-blockers in critically ill patients are still lacking. The purpose of this document is to support the clinical decision-making process regarding the use of β-blockers in critically ill patients. The recipients of this document are physicians, nurses, healthcare personnel, and other professionals involved in the patient's care process.

methodsThe Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) selected a panel of experts and asked them to define key aspects underlying the use of β-blockers in critically ill adult patients. The methodology followed by the experts during this process was in line with principles of modified Delphi and RAND-UCLA methods. The experts developed statements and supportive rationales in the form of informative text. The overall list of statements was subjected to blind votes for consensus.

resultsThe literature search suggests that adrenergic stress and increased heart rate in critically ill patients are associated with organ dysfunction and increased mortality. Heart rate control thus seems to be critical in the management of the critically ill patient, requiring careful clinical evaluation aimed at both the differential diagnosis to treat secondary tachycardia and the treatment of rhythm disturbance. In addition, the use of β-blockers for the treatment of persistent tachycardia may be considered in patients with septic shock once hypovolemia has been ruled out. Intravenous application should be the preferred route of administration.

conclusionβ-blockers protective effects in critically ill patients have been repeatedly reported in the literature. Their use in the acute treatment of increased heart rate requires understanding of the pathophysiology and careful differential diagnosis, as all causes of tachycardia should be ruled out and addressed first.

Indexed as

AdultsCritically ill patientICUSepsisTachyarrhythmiaβ-blockers

Identifiers

PMID37872608
PMCPMC10591347
OpenAlexW4387875866

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.