Several data emphasize the relation between tachycardia (\>90/min) and high mortality during septic shock. The investigators previously demonstrated the high mortality associated with hypercontractility, tachycardia and the presence of a left ventricular obstruction. A severe hypovolemia, a hyper adrenergic stimulation or a severe vasoplegia can all explain this relation between tachycardia, hypercontractility and the mortality during septic shock.
Landiolol is another short-term acting beta-blocker with a half-life of 4 minutes without any beta 2 activity or membrane stabilizing effect. The landiolol has been used in critically ill patients to control supraventricular tachycardia but not in this context of tachycardia and septic shock. The investigators hypothesize that landiolol by reducing the heart rate may improve the survival of patients treated for a septic shock and presenting with an hypercontractility state.
Age ≥ 18 years old
Patient admitted for a septic shock (according to the SEPSIS3 definition: sepsis with persisting hypotension (MAP<65mmHg or SAP <90mmHg) requiring vasopressors to maintain MAP>65mmHg and having a serum lactate level >2 mmol/L
Patient who received at least 30ml/kg of fluid and absence of fluid responsiveness
Left ventricular ejection fraction >65% (visual or Simpson method using echocardiography)
Patients with inclusion criteria already present for more than 36 hours
Patient treated with Dobutamine, adrenaline or isoprenaline
Patient currently treated with beta blockers (previous home betablocker treatment is not an exclusion criteria)
Supra ventricular (atrial fibrillation or flutter) or ventricular arrhythmias
Centre Hospitalier Universitaire, Amiens
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CH Dieppe
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CH Elbeuf
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CH Le Havre
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Centre Hospitalier de Beauvais
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CH Compiègne
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CH Laon
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University Hospital, Caen
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CH Cherbourg
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University Hospital, Lille
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CH Douai
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CH Montreuil
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Centre Hospitalier de Roubaix
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Centre Hospitalier de Bethune
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CH Lomme
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Centre Hospitalier de Lens
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Tourcoing Hospital
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Centre Hospitalier VALENCIENNES
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Centre Hospitalier Arras
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Hospital Ambroise Paré Paris
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University Hospital, Brest
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Henri Mondor University Hospital
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Hospital Avicenne
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University Hospital, Montpellier
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CH Calais
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Hôpital Edouard Herriot
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Centre Hospitalier Universitaire de Nīmes
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Groupe Hospitalier Pitie-Salpetriere
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Hôpital Louis Mourier, Colombes
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