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Commentary

Myocardial protection in sepsis

Simon Shakar* and Brian D Lowes

Author Affiliations

Division of Cardiology, University of Colorado Denver, Aurora, CO 80045, USA

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Critical Care 2008, 12:177 doi:10.1186/cc6978

Published: 3 September 2008

Abstract

Sepsis with myocardial dysfunction is seen commonly. Beta-blockers have been used successfully to treat chronic heart failure based on the premise that chronically elevated adrenergic drive is detrimental to the myocardium. However, recent reports on the acute use of beta-blockers in situations with potential hemodynamic compromise have shown the risks associated with this approach. In critical situations, the main effect of adrenergic activation is to support cardiovascular function. Caution should be exercised in designing studies to assess beta-blockers in septic patients.