Author: Guck, Jonathan

Eligibility Inclusion Criteria
Aged 18 years or above
Being treated on an ICU
Septic shock according to internationally accepted definitions
Heart rate ≥95 bpm (24 hours after start of vasopressor therapy)
Receiving vasopressor support to maintain target blood pressure for ≥24 hours
Treated with noradrenaline at rate ≥0.1mcg/kg/min

EudraCT No. 2017-001785-14 Protocol Version No. 6.0 26 June 2020

Tachycardia as a result of pain, discomfort from medical devices (including endotracheal tubes), during interventions or other patient distress
Any form of Vasodilatory Shock that is not caused by sepsis
Noradrenaline infusion <0.1mcg/kg/min
>72 hours in the current cause of septic shock after starting vasopressor therapy
<12 hours since noradrenaline to treat a medical condition other than septic shock stopped
Having pre-existing severe cardiac dysfunction (NYHA Grade 4 or more)
Having pre-existing severe pulmonary hypertension (mean PA pressures >55mmHg)
Acute severe bronchospasm (due to asthma/COPD)
Untreated 2nd or 3rd degree heart block
Untreated pheochromocytoma
Prinzmetal’s angina
A past history of transient ischaemic stroke (TIA) or untreated severe carotid stenosis
Advanced liver disease with Child-Pugh Score of ≥B
Known sensitivity to beta-blocker
Patient/legal representative unwilling to provide written informed consent
Known to be pregnant
Terminal illness other than septic shock with a life expectancy <28 days
Patients who have been administered an investigational medicinal product for another research trial in the past 30 days
Decision of withdrawal of care is in place or imminently anticipated
Patients in whom the clinical team feel are about to finish noradrenaline therapy
Decision of withdrawal of care is in place or imminently anticipated
Receiving extracorporeal membrane oxygenation (ECMO)

Eligibility Exclusion Criteria

EudraCT No. 2017-001785-14 Protocol Version No. 6.0 26 June 2020

EudraCT No. 2017-001785-14 Protocol Version No. 4.0 2 Apr 2019