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Beta-adrenergic antagonists: indications and potential immunomodulatory side effects in the critically ill.

Authors
  • Oberbeck, Reiner
  • Kobbe, Philipp
Type
Published Article
Journal
Current medicinal chemistry
Publication Date
Jan 01, 2009
Volume
16
Issue
9
Pages
1082–1090
Identifiers
PMID: 19275613
Source
Medline
License
Unknown

Abstract

Pharmacologic blockade of beta-adrenergic receptors is a frequent therapeutic intervention in critically ill patients. Today's strategies predominantly include the treatment of cardiovascular diseases like hypertension and cardiac arrhythmias. Furthermore, beta-adrenergic antagonists are routinely used to prevent the catecholamine-induced hypermetabolism in critically ill patients suffering from severe burn injury. In addition to these well known beneficial effects of beta-adrenoceptor blocking agents it has been demonstrated, that the adrenergic system is involved in the modulation of cellular immune functions. Therefore, the immunomodulatory properties of beta-adrenergic antagonists have been established during the last years and the scientific focus was addressed on the proposed immunologic side effects of a beta-adrenergic blockade and its potential effect on the clinical course of critical illness. This manuscript reviews the rational and the effect of the therapeutic use of beta-adrenergic antagonists in critically ill patients on the base of the current literature and further emphasizes on potential immunologic side effects.

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