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Beta-Adrenergic Antagonists: Indications and Potential Immunomodulatory Side Effects in the Critically Ill

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Pharmacologic blockade of β-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, β-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 β-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 β-adrenergic antagonists have been established during the last years and the scientific focus was addressed on the proposed immunologic side effects of a β-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 β-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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Keywords: Propranolol; adrenergic antagonist; critical care medicine; critical illness; endocrine-immune interaction; immune system; β-blocker

Document Type: Research Article

Affiliations: Department Trauma Surgery, University Hospital of Essen, Hufelandstr. 55, 45147 Essen, Germany.

Publication date: 2009-03-01

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