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
ARTICLE HIGHLIGHTS
Research background

Cardiopulmonary bypass (CPB) provides good perioperative protection for patients undergoing cardiac surgery. However, perioperative cardiac injury related to CPB remains a severe complication in these patients and affects their prognosis.

Research motivation

Inflammation and oxidative stress play an important role in the CPB-related heart injury, and clinical observations have confirmed the protective effect of Xuebijing injection (XBJ) on multiple organs against inflammatory damage.

Research objectives

To evaluate the potential efficacy of XBJ on cardiac injury during CPB.

Research methods

Sixty patients who underwent cardiac surgery with CPB in our center between November 1, 2018 and February 1, 2019 were included. XBJ was injected intravenously 3 times: 12 h before the operation, at the beginning of the operation, and 12 h after the second injection. The heart function was assessed by echocardiography 48 h after the operation. Markers related to circulatory inflammation and oxidative stress were measured and clinical results at intensive care unit (ICU) were recorded.

Research results

All the 60 patients were successfully weaned from CPB and transferred to the ICU. Compared to the control group, XBJ improved PaO2/FiO2 and cardiac systolic function, but reduced troponin I and creatine kinase fraction after surgery (all P < 0.05). Moreover, the circulating concentrations of TNF-α, 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 statistically significant.

Research conclusions

Perioperative administration of XBJ was associated with attenuated cardiac injury during the CPB surgery, likely via anti-inflammation– and anti-oxidation–related mechanisms.

Research perspectives

Further research is required with more meaningful data to accurately evaluate the efficacy of XBJ on cardiac injury during CPB, and clarify the mechanism of action of XBJ.