Abstract:Objective To investigate the effect of ultrasound-guided fluid resuscitation combined with esmolol on oxygen metabolism indicators and inflammatory levels in patients with septic shock. Methods A total of 122 patients with septic shock admitted to Affiliated Hospital of Hebei University of Engineering from June 2021 to June 2023 were selected and randomly divided into a control group and a treatment group，with 61 cases in each group. All patients received conventional treatments including fluid resuscitation for anti-shock，application of vasoactive drugs，anti-infection，immune regulation，and organ function support. The control group was treated with ultrasound-guided fluid resuscitation，while the treatment group was additionally treated with esmolol based on the control group. Oxygen metabolism indicators［oxygen consumption（VO2），oxygen delivery（DO2）］，inflammatory factors［interleukin-6（IL-6），C-reactive protein（CRP）］，6-hour lactate clearance rate，mortality rate during treatment，hemodynamic indicators［mean arterial pressure（MAP），central venous pressure（CVP）］，and myocardial related indicators［creatine kinase-MB（CK-MB），brain natriuretic peptide（BNP），cardiac troponin I（cTnI）］were compared between the two groups.Results After treatment，the levels of IL-6，CRP，CK-MB，BNP，and cTnI decreased in both groups，and those in the treatment group were significantly lower than those in the control group（P＜0.05）. The levels of VO2，DO2，MAP，and CVP increased in both groups，and those in the treatment group were significantly higher than those in the control group（P＜0.05）. The 6-hour lactate clearance rate in the treatment group was significantly higher than that in the control group［（86.21±9.35）% vs（81.52±8.69）%，t=2.870，P=0.005］. There was no significant difference in mortality rate during treatment between the two groups（P＞0.05）. Conclusion Ultrasound-guided fluid resuscitation combined with esmolol can effectively improve oxygen supply-consumption balance，enhance tissue oxygen delivery capacity，stabilize hemodynamics，inhibit the release of inflammatory factors，reduce systemic inflammatory response，and improve myocardial function in patients with septic shock，which has clinical application value.