Effect of heart rate control with Ivabradine on hemodynamic in patients with sepsis: a prospective, multicenter, randomized controlled trial

INTERVENTION: Ivabradine group:Standard treatment for sepsis plus enteral ivabradine.;Standard treatment group:Standard treatment for sepsis; CONDITION: Sepsis PRIMARY OUTCOME: Heart rate;Blood pressure;Stroke index;Cardiac Index;Dynamic and venous blood gas analysis;Myocardial enzymology ;Lactate;Procalcitonin;C‐reactive protein;interleukin‐6;Tumor necrosis factor‐a; SECONDARY OUTCOME: blood routine examination;Serological test of liver and kidney function;Brain natriuretic peptide; INCLUSION CRITERIA: Patients who meet the following criteria are eligible to be included in the trial: (1) Adult patients aged 18 years or above. (2) Being treated in an intensive care unit. (3) Sepsis is diagnosed according to Sepsis‐3.0 criteria, which is defined as patients requiring antimicrobial agents due to confirmed or suspected infection, acute increase in the SOFA score at least 2 points. (4) Mean arterial pressure (MAP) is maintained >=65 mmHg with adequate volume resuscitation and vasopressor therapy. Volume resuscitation is considered adequate when Central Venous Pressure (CVP) > 8mmHg, global end‐diastolic volume inde X(GEDI) > 680ml/m2 and resting inferior vena cava (IVC) diameter > 1.5cm. (5) Sinus rhythm with heart rate >= 95bpm maintain for at least 2 hours but less than 72 hours.