The impact of beta2-agonists (B2As) on heart failure (HF) remains controversial. This study aimed to investigate whether inhaled B2As increased in-hospital mortality in ICU patients with HF.

The Multiparameter Intelligent Monitoring in Intensive Care III database was initially searched to identify adult patients (≥ 18 years old) with HF in ICU. Then, patients using or not using inhaled B2As were matched using propensity score matching on a 1:1 basis to control for baseline confounders. In-hospital mortality was compared between the two groups, and logistic regression analysis was performed to assess the association between B2As and in-hospital mortality.

The initial search retrieved 2345 eligible patients with HF from the database. After propensity score matching, 705 pairs of patients were included in the final analysis. Patients using B2As had markedly higher in-hospital mortality than those not using B2As (4.68% versus 2.27%; P = 0.013). In the multivariate logistic regression analysis, B2A use (odd ratios (OR), 2.471; 95% confidence interval (CI), 1.289-4.734; P = 0.006), stroke (OR, 4.581; 95% CI, 1.621-12.948; P = 0.004), and simplified acute physiology score II (SAPS-II) scores (OR, 1.090; 95% CI, 1.064-1.116; P < 0.001) were significantly associated with increased risk of in-hospital mortality, whereas renin angiotensin system inhibitor use (OR, 0.396; 95% CI, 0.202-0.778; P = 0.007) was significantly associated with decreased risk of in-hospital mortality. Subgroup analysis further indicated that the association between B2A use and mortality was significant only in patients with HF without chronic pulmonary disease (OR, 2.427; 95% CI, 1.351-4.362; P = 0.003), but not in those with chronic pulmonary disease (OR, 2.094; 95% CI, 0.582-7.537; P = 0.258).

In ICU patients with HF but without chronic pulmonary disease, the use of inhaled B2As is associated with increased in-hospital mortality.

β2-激动剂 (B2As) 对心力衰竭 (HF) 的影响仍然存在争议。本研究旨在调查吸入 B2As 是否会增加 ICU HF 患者的院内死亡率。

最初搜索重症监护中的多参数智能监测 III 数据库以识别 ICU 中的 HF 成年患者（≥ 18 岁）。然后，使用或不使用吸入 B2As 的患者在 1:1 的基础上使用倾向评分匹配进行匹配，以控制基线混杂因素。比较两组的院内死亡率，并进行逻辑回归分析以评估B2As与院内死亡率之间的关联。

最初的搜索从数据库中检索了 2345 名符合条件的 HF 患者。倾向评分匹配后，705对患者被纳入最终分析。使用 B2As 的患者的院内死亡率明显高于不使用 B2As 的患者（4.68% 对 2.27%；P = 0.013）。在多变量逻辑回归分析中，B2A 使用（奇数比 (OR)，2.471；95% 置信区间 (CI)，1.289-4.734；P = 0.006），卒中（OR，4.581；95% CI，1.621-12.948；P = 0.004) 和简化急性生理学评分 II (SAPS-II) 评分（OR，1.090；95% CI，1.064-1.116；P < 0.001）与院内死亡风险增加显着相关，而肾素血管紧张素系统抑制剂使用（OR，0.396；95% CI，0.202-0.778；P = 0.007）与院内死亡风险降低显着相关。亚组分析进一步表明，B2A 的使用与死亡率之间的关联仅在无慢性肺病的 HF 患者中显着（OR，2.427；95% CI，1.351-4.362；P = 0.003），但在患有慢性肺病的患者中不显着（ OR，2.094；95% CI，0.582-7.537；P = 0.258）。

在患有心力衰竭但没有慢性肺部疾病的 ICU 患者中，吸入 B2As 的使用与院内死亡率增加有关。