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Effects of Shenfu Injection on Heart Function and Serum Biomarkers in Septic Shock
Ling Liang1, Hongling Wang2, Huixia Duan3
1Department of Critical Care, Wuhan University of Science and Technology Affiliated Puren Hospital.
Insights
Shenfu injection (SFI) improved cardiac function and reduced inflammatory markers in septic shock patients. This traditional Chinese medicine enhanced prognosis, lowering mortality and ICU stay compared to standard care alone.
Area of Science:
- Cardiology
- Intensive Care Medicine
- Pharmacology
Background:
- Septic shock frequently causes myocardial depression, impacting patient outcomes.
- Evidence for traditional Chinese medicine, like Shenfu injection (SFI), in treating septic shock-induced cardiac dysfunction is limited.
- Evaluating SFI's efficacy in improving cardiac function and biomarkers in septic shock is crucial.
Purpose of the Study:
- To assess the effects of Shenfu injection (SFI) on cardiac function and serum biomarkers in patients with septic shock.
- To compare outcomes between patients receiving standard care plus SFI and those receiving standard care alone.
Main Methods:
- Retrospective case-control study of 186 septic shock patients (January 2019 - December 2023).
- Patients were divided into a Control group (standard care) and an SFI group (standard care + SFI) for 7-day continuous intravenous infusion.
- Evaluated cardiac function (LVEF, cTnI, NT-proBNP), inflammatory markers (IL-6, PCT, CRP), tissue perfusion (Lac, ScvO2), hemodynamics (MAP, CI), organ function (creatinine, ALT), and clinical prognosis (mortality, ICU stay).
Main Results:
- The SFI group demonstrated significant improvements in left ventricular ejection fraction (LVEF) and reductions in cardiac troponin I (cTnI), N-terminal pro-B-type natriuretic peptide (NT-proBNP), interleukin-6 (IL-6), procalcitonin (PCT), and blood lactate (Lac) compared to the Control group (P < 0.05).
- Hemodynamic parameters including mean arterial pressure (MAP), central venous oxygen saturation (ScvO2), and cardiac output index (CI) were significantly higher in the SFI group.
- The SFI group experienced a lower 28-day mortality rate (51.61% vs. 70.97%), shorter ICU stay (9.45 vs. 13.75 days), and reduced vasopressor use (P < 0.05).
Conclusions:
- Adjunctive Shenfu injection (SFI) significantly improves cardiac function in septic shock patients.
- SFI reduces myocardial injury markers and inflammatory factor levels, contributing to better tissue perfusion and hemodynamic stability.
- The combination of SFI with standard care positively impacts patient prognosis, evidenced by reduced mortality and shorter ICU duration.
Abstract:
Septic shock often induces severe myocardial depression. Shenfu injection (SFI), a traditional Chinese medicine, requires more evidence for its efficacy in this condition. We describe a method to evaluate the effects of SFI on cardiac function and serum biomarkers in patients with septic shock. This retrospective case-control investigation included 186 patients hospitalized with septic shock between January 2019 and December 2023. Based on the therapeutic regimen, participants were allocated to either a Control group receiving standard care alone (n=93) or an SFI group receiving standard care augmented by SFI (n=93). They were intravenously infused continuously for 7 days. The detection indicators included the following: Cardiac function indicators: ejection fraction (LVEF), cardiac troponin I (cTnI), N-terminal pro-B-type natriuretic peptide (NT-proBNP); inflammatory indicators: interleukin-6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP); tissue perfusion indicators: blood lactate (Lac), central venous oxygen saturation (ScvO2); hemodynamic parameters: mean arterial pressure (MAP), cardiac output index (CI); organ function indicators: creatinine, alanine aminotransferase (ALT); clinical prognosis indicators: 28-day mortality rate, ICU stay time. After 7 days, the SFI group showed significant improvements in LVEF (45.72% vs. 39.05%), and reductions in cTnI, NT-proBNP, IL-6, PCT, and Lac compared to the Control group (all P < 0.05). MAP, ScvO2, and CI were also significantly higher in the SFI group. Clinically, the SFI group had a lower 28-day mortality rate (51.61% vs. 70.97%), a shorter ICU stay (9.45 vs. 13.75 days), and reduced duration of vasopressor use (P < 0.05). This retrospective study shows that, in addition to conventional treatment, the combination of SFI can improve the cardiac function of patients with septic shock, reduce myocardial injury markers and inflammatory factor levels, and have a positive significance for the improvement of patient prognosis.
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