Effects of Shenfu Injection on Heart Function and Serum Biomarkers in Septic Shock

Summary

This retrospective cohort study of 186 patients demonstrates that adjunctive Shenfu injection significantly improves cardiac function, reduces biomarkers of injury and inflammation, and lowers 28-day mortality in septic shock.

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.

Introduction

Sepsis represents a major global health challenge, characterized by a maladaptive host reaction to infection resulting in potentially fatal impairment of organ function. Its characteristic manifestations include bilateral ventricular dilation, decreased ejection fraction, and elevated myocardial markers. As a circulatory failure state caused by severe infection, it is one of the most challenging clinical syndromes in the field of critical care medicine. Its pathophysiological mechanism is complex, involving multiple links such as uncontrolled systemic inflammatory response, microcirculation disorders, and abnormal cellular metabolism, ultimately resulting in multiple ....

Protocol

This study was approved by the Wuhan University of Science and Technology Affiliated Puren Hospital Ethics Committee. The research plan received approval from the ethics committee of each hospital involved as well. All data were strictly de-identified to ensure patient privacy. We secured a signed informed consent form from every participant.

Research subjects
This study employed a multi-center, retrospective cohort design to systematically evaluate the effects of SFI on cardiac function and serum biomarkers in patients with septic shock. The study subjects were 193 patients with septic shock who were admitted to the ....

Results

Baseline information comparison
A total of 186 patients meeting the diagnostic criteria for septic shock were included in this study and were randomly assigned to the SFI treatment group (SFI, n = 93) and the control group (conventional treatment, n = 93). There were no statistically significant differences in key baseline indicators such as age, gender, body mass index (BMI), SOFA score reflecting the severity of the disease, distribution of infection sources, heart rate, systolic blood pressure, an.......

Discussion

SFI enhances left ventricular function in septic shock
This study aims to conduct a rigorous clinical observation and systematically evaluate the intervention effect of SFI-assisted standard treatment on the core cardiac function indicators, key serum biomarker profiles, and final clinical outcomes of patients with septic shock. The goal is to provide high-level evidence-based medical evidence for its standardized application in the critical care field. The primary and most clinically significant f.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
BioMerieux Vidas 99735 Immunoassay Analyzer	Merieux VIDAS	REF 99735	Main tests: 1. Infectious diseases: HIV-p24 antigen, hepatitis B five items, hepatitis C antibody, respiratory syncytial virus, etc. 2. Cardiac markers: Troponin I, B-type natriuretic peptide, etc., used for auxiliary diagnosis of acute coronary syndrome and heart failure. 3. Microbial toxins: Crucial for the diagnosis of Clostridioides difficile infection (CDI).
cobas b 123 Blood gas analyzer	Philips	cobas b 123 POC system	A fully automatic blood gas analyzer designed for rapid bedside testing in critical care units, capable of quickly detecting up to 17 key indicators including blood gas, electrolytes, blood oxygen and metabolites.
G*Power	Universität Kiel	Version 3.1.9.7
glucose injection	China Dazhong Pharmaceutical Co., Ltd.)	H12020022
Philips MP60 monitor	Philips	M8005A/M8007A	Electrocardiogram (ECG), respiration, non-invasive/invasive blood pressure, pulse oxygen saturation (SpO2), body temperature, cardiac output/continuous cardiac output, electroencephalogram, carbon dioxide, anesthetic gases, etc.
SFI Injection solution	Huarun Sanjiu (Ya'an) Pharmaceutical Co., Ltd.	No.Z20043117	Each bottle contains 50ml, injection.
SPSS	IBM SPSS Statistics