Randomized Controlled Trial
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2022; 10(13): 4110-4118
Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4110
Effect of Xuebijing injection on myocardium during cardiopulmonary bypass: A prospective, randomized, double blind trial
Zhe-Hao Jin, Xiao-Qing Zhao, Hai-Bin Sun, Jing-Li Zhu, Wei Gao
Zhe-Hao Jin, Xiao-Qing Zhao, Hai-Bin Sun, Jing-Li Zhu, Wei Gao, Department of Anesthesiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Author contributions: Jin ZH and Gao W designed the study; Jin ZH and Zhao XQ collected the intraoperative data; Sun HB and Zhu JL collected the postoperative data; Gao W analyzed the data and Jin ZH wrote the paper.
Institutional review board statement: The protocol for the present study was approved by the ethics committee of the Second Affiliated Hospital of Harbin Medical University before the performance of the study (HMUIRB20140012).
Clinical trial registration statement: A predefined study protocol was registered with the Chinese Clinical Trial Registry (ChiCTR-TRC-14004628).
Informed consent statement: An informed consent form was signed by each patient or their legal guardian before enrollment.
Conflict-of-interest statement: All authors have no any conflicts of interest.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Gao, MD, Doctor, Department of Anesthesiology, The 2nd Affiliated Hospital of Harbin Medical University, No.246 Xuefu Road,Nangang District, Harbin 150001, Heilongjiang Province, China. gaowei20055@126.com
Received: September 1, 2021
Peer-review started: September 1, 2021
First decision: November 11, 2021
Revised: November 23, 2021
Accepted: March 16, 2022
Article in press: March 16, 2022
Published online: May 6, 2022
Processing time: 241 Days and 4.9 Hours
Abstract
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.

Keywords: Xuebijing injection; Cardiopulmonary bypass; Cardiac injury; Cardioprotection; Circulating inflammation; Oxidative stress

Core Tip: Xuebijing injection (XBJ) significantly reduced myocardial injury in patients undergoing cardiopulmonary bypass (CPB), as demonstrated by significantly lower levels of myocardial injury markers including troponin I and creatine kinase-MB, and the preserved cardiac ejection fraction in patients in the XBJ group compared with those in the control group. The benefit of XBJ against myocardial injury was accompanied by reduced serum concentrations of inflammatory markers, including tumor necrosis factor-α, interleukin (IL)-1β and IL-8 and an increase in anti-inflammatory factor IL-10. These results suggest that perioperative XBJ is associated with attenuated cardiac injury during CPB, likely via anti-inflammatory and antioxidative mechanisms.