Use of Landiolol for Patients With Septic Shock and Organ Failure / Reply

The authors of this letter respond to a study on the use of landiolol for patients with septic shock and organ failure. They raise three points of concern regarding the study. First, they note that the study did not monitor hemodynamic effects, such as cardiac output or central venous oxygen saturation, which could have influenced the results. Second, they suggest that factors other than landiolol use may have affected the difference in mortality between the treatment and control groups. Lastly, they argue that the difference in mean heart rate between the groups may not be clinically meaningful. The authors conclude that while landiolol may have beneficial characteristics for certain patients, the study's findings do not support its routine use in patients with septic shock. They suggest that further research should be conducted in specific populations using different criteria for eligibility and monitoring. In response, the authors of the original study acknowledge the concerns raised and provide additional insights. They explain that their research hypothesis was based on the potential benefits of selective 1-receptor blockade in a high-risk population with septic shock. They also address the lack of hemodynamic monitoring in their study and discuss the limitations of their findings. They emphasize the need for future trials to investigate the use of landiolol in specific populations and with different treatment ranges.