Is There a Role for β-Blockade in Septic Shock?

Single-cell and multicell organisms have developed elaborate networks to minimize injury, repair damage, and fend off invasion by other organisms¹ with the goal of maximizing the probability of surviving overwhelming stress. These networks in higher organisms were described by Walter Cannon² as the acute stress response. The acute stress response includes centrally mediated sympathetic neural and humoral activation, increased vascular smooth muscle tone, catecholamine and cortisol release into the bloodstream, minimized pain perception, altered intercellular and intracellular signaling and intermediary metabolism, and a proinflammatory, prothrombotic intravascular state.