Comparison of Esmolol Versus Landiolol on Mortality in Adult Patients With Sepsis: A Systematic Review and Network Meta-Analysis
Authors' conclusion
Among patients with sepsis treated with β-blockers, esmolol probably improves clinical outcomes compared with SOC. However, the effect of landiolol remains uncertain due to the low certainty of evidence.
Study context
- Population
- Adults (≥ 18 yr) with sepsis or septic shock treated with β-blockers in ICUs
- Participants
- 1,035 adults · 10 studies
- Comparison
- Esmolol vs landiolol vs standard of care (SOC)
- Outcome
- Mortality
- Follow-up
- 28 days
Pooled result
As reported in the abstract
28-day mortality
Relative risk (95% CI)
Landiolol vs Esmolollow certainty
1.57(1.08–2.30)
Esmolol vs SOCmoderate certainty
0.69(0.56–0.85)
Further pooled results
| Outcome | MD (μg/kg/min) (95% CI) | |
|---|---|---|
| Norepinephrine requirementsLandiolol vs Esmolol · low certainty | 0.17 (0.02–0.32) | |
| Norepinephrine requirementsLandiolol vs SOC · moderate certainty | 0.09 (0.01–0.18) | |
| −0.200.20.4Difference, μg/kg/min (linear scale) |
| Outcome | MD (beats/min) (95% CI) | |
|---|---|---|
| Heart rate · 24 hoursEsmolol vs SOC · moderate certainty | −16.92 (−23.49 to −10.36) | |
| −30−20−10010Difference, beats/min (linear scale) |
Original publication
Comparison of Esmolol Versus Landiolol on Mortality in Adult Patients With Sepsis: A Systematic Review and Network Meta-Analysis. Crit Care Med. Published 25 November 2025. doi:10.
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