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Published on: September 15, 2023
Effect of Xuebijing injection on myocardium during cardiopulmonary bypass: A prospective, randomized, double blind
Zhe-Hao Jin1, Xiao-Qing Zhao1, Hai-Bin Sun1
1Department of Anesthesiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China.
Insights
Xuebijing injection (XBJ) may protect the heart during cardiac surgery. This Chinese medicine preparation reduced cardiac injury markers and inflammation in patients undergoing cardiopulmonary bypass (CPB).
Area of Science:
- Cardiology
- Pharmacology
- Traditional Chinese Medicine
Background:
- Cardiopulmonary bypass (CPB) is crucial for cardiac surgery but can cause perioperative cardiac injury.
- Effective cardiac protection strategies are vital for patients undergoing CPB.
Purpose of the Study:
- To assess the cardioprotective effects of Xuebijing injection (XBJ), a Chinese medicine preparation, in patients undergoing CPB.
Main Methods:
- A randomized controlled trial involving 60 patients undergoing cardiac surgery with CPB.
- Patients received either XBJ or saline (control) intravenously at specific pre- and post-operative time points.
- Cardiac function, inflammation markers, oxidative stress markers, and clinical outcomes (ICU stay) were evaluated.
Main Results:
- XBJ improved oxygenation (PaO2/FiO2) and cardiac systolic function.
- XBJ reduced levels of cardiac injury markers (troponin I, creatine kinase) and pro-inflammatory cytokines (TNF-α, IL-1β, IL-8).
- XBJ increased anti-inflammatory cytokine IL-10 and showed a trend towards shorter ICU and hospital stays.
Conclusions:
- Perioperative administration of XBJ attenuates cardiac injury during CPB.
- The cardioprotective effects of XBJ are likely mediated by anti-inflammatory and antioxidative mechanisms.
Background:
Cardiopulmonary bypass (CPB) is an essential procedure for maintaining the blood supply to vital organs in patients undergoing cardiac surgery. However, perioperative cardiac injury related to CPB remains a severe complication in these patients. Cardiac protection is important for patients undergoing CPB.
Aim:
To evaluate the potential cardioprotective efficacy of the Chinese medicine preparation Xuebijing injection (XBJ) in patients undergoing CPB.
Methods:
Sixty patients undergoing cardiac surgery with CPB were randomly allocated to the XBJ and control groups (saline). XBJ was administered intravenously three times: 12 h prior to surgery, at the beginning of the surgery, and 12 h after the second injection. Cardiac function was evaluated by echocardiography 48 h after surgery. Circulating inflammation- and oxidative-stress-related markers were measured. Clinical outcomes related to intensive care unit (ICU) stay were recorded.
Results:
Compared to control treatment, XBJ was associated with improved PaO2/FiO2 and cardiac systolic function, but reduced troponin I and creatine kinase fraction after surgery (all P < 0.05). The circulating concentrations of tumor necrosis factor-α, interleukin (IL)-1β and IL-8 in the XBJ group were significantly lower than those in the control group (all P < 0.05), whereas the circulating concentration of IL-10 was significantly higher in the XBJ group (P < 0.05). In addition, the lengths of ICU stay and hospitalization after surgery tended to be shorter in the XBJ group than in the control group, although the differences were not significant.
Conclusion:
Perioperative administration of XBJ was associated with attenuated cardiac injury during CPB, likely via anti-inflammatory and antioxidative mechanisms.
