LANdiolol MIcrocirculatory Effects During Septic chOc (MILANOS)

Inclusion Criteria:

• Sinus tachycardia not compensatory, if the doctor considers that the heart rateacceleration should be treated.

• The study will be carried out in

• reanimated and stabilized septic shock defined as:

• Septic shock is tachycardic (HR>100/min) patients with sepsis (suspectedinfection + 2 SOFA points) according to the latest international definition andthe need to receive noradrenaline to maintain an average blood pressure above 65 mmHg

• Patient supported for at least 6 hours, necessary for diagnostic management andhemodynamic optimization according to international standards and for less than 24 hours to limit confounding factors related to prolonged reanimation (sedation) and empowerment of organ failure in general and vascular inparticular. Hemodynamic stabilization will be defined as the absence ofincreased doses of norepinephrine in the previous two hours to limit the riskof hypotension induced by Landiolol infusion.

• Age >18 years

• Patient (or family member) informed consent signature or emergency consent

• Affiliation to a social security system

Exclusion Criteria:

• Asthma

• Patients treated with the following bradycardizing drugs:

• Digitalis

• Bradycardizing calcium channel blockers

• Cordarone

• Other beta-blocker

• Hypersensitivity to Landiolol or to one of its excipients (Mannitol E421, sodiumhydroxide)

• Sinus disease

• Cardiogenic shock

• Decompensated heart failure when considered unrelated to arrhythmia

• Pregnant or nursing woman,

• Participation in another interventional research involving the human person or beingin the exclusion period following a previous research involving the human person, ifapplicable

• Ward or curative patient

• Moribund patient

• Estimated life expectancy less than 1 month