Beta-Blocker Therapy for Septic Cardiac Shock: Fiction Or Realism?

Beta-blockers, previously considered contraindicated in heart failure are today amongst the most important drugs in heart failure. They improve survival and retard the need for cardiac transplantation. Since most clinical trials demonstrating the benefits of beta-blockers have been done in patients with mild to moderate heart failure, the use of these agents in patients with advanced heart failure remains contraindicated. In this brief review, the author theorizes that due to their immunomodulatory effects, beta-blockers may also play a helpful role in patients presenting cardiogenic shock related to septic shock. However, intensivists should keep in mind that no clinical data are available so far on the role of beta-blockers in septic cardiac shock. Thereby, because the use of beta-blockers in this setting is not established, nor recommended, it should only be applied under controlled trial conditions.