Effects of Shen-Fu injection on mitochondrial function in the intestinal epithelial cells of rats with endotoxemia.

Recently, several studies have demonstrated that reactive oxygen species are responsible for inducing multiple organ failure and septic shock. Particularly, mitochondrial dysfunction has been demonstrated in the pathogenesis of multiple organ dysfunction syndrome (MODS). In cytopathic hypoxia, impairment of mitochondrial oxidative phosphorylation decreases aerobic adenosine triphosphate (ATP) production and potentially induces MODS. Shen-Fu (SF) injections are widely used in the treatment of various diseases. SF exhibits cardiovascular protective effects. For example, it can stretch the coronary artery, stabilize blood pressure, regulate IRI, and improve the overall heart function. Clinical studies have demonstrated that SF injections have notable therapeutic effects on septic and hemorrhagic shocks. In the present study, the effects of SF injection on mitochondrial function in the intestinal epithelial cells of rats with endotoxemia were analyzed.

Experimental study of airway pressure release ventilation in the treatment of acute respiratory distress syndrome.

Airway pressure release ventilation (APRV) is a ventilator mode which has demonstrated potential benefits in acute respiratory distress syndrome (ARDS) patients. We therefore sought to compare relevant pulmonary data and safety outcomes of this mode to the conventional ventilation and sustained inflation. Canines admitted after intravenous injection of oleic acid requiring mechanical ventilation were randomly divided into 3 groups (n=6), namely conventional ventilation group, low tidal volume ventilation with recruitment group (LTV+SI) and APRV group. The changes of oxygenation, ventilation, airway pressure, inflammatory reaction and hemodynamics at the basic state were observed at 0, 1, 2 and 4 h during the experiment. The levels of PaO2/FiO2 in APRV group were higher than LTV+SI group at 2 and 4 h (P<0.05). In APRV group, the PCO2 levels at 1, 2 and 4 h is much lower than LTV+SI group (P<0.05). Outcome variables showed no differences between APRV, LVT+SI and conventional mechanical ventilation for plateau airway pressure (24±1 vs. 29±3 vs. 25±4), mean arterial pressure (92.9±16.5 vs. 85.8±21.4 vs. 88.7±24.4), cardiac index (4.3±1.7 vs. 3.5±1.9 vs. 3.4±2.1), ERO2 (13.4±10.3 vs. 16.1±6.8 vs. 17.6±9.1), lac (2.5±1.7 vs. 3.1±1.6 vs. 3.9±1.9), tumor necrosis factor (TNF)-α (132±11 vs. 140±6 vs. 195±13) and matrix metalloproteinase (MMP)-9. For canines sustaining acute respiratory distress syndrome requiring mechanical ventilation, APRV can significantly improve oxygenation and keep hemodynamic stability compared with LTV+SI. The results of TNF-α and MMP-9 suggest that APRV could be as protective for ARDS as LTV with recruitment group.

Effect of the Shenfu Injection Combined with Early Goal-Directed Therapy on Organ Functions and Outcomes of Septic Shock Patients.

Shenfu injection (SFI) derived from traditional Chinese medicine has been widely used in cardiovascular diseases. The objective of this study was to determine the effect of SFI and conventional early goal-directed therapy (EGDT) on organ functions and outcomes of septic shock patients. For this purpose, a total of 45 septic shock patients were randomly divided into control group A (24 patients on EGDT) and experimental group B (21 patients on SFI + EGDT). SFI was administered (100@20 mL/h) twice daily. Hemodynamic status, lactic acid, and vasoactive drug use were observed before and after treatment. Other indicators included ventilator weaning time, ICU stay time, free of organ failure time, and 28-day hospital mortality. Regarding experimental group, compared with controls, BUN/creatinine decreased significantly at 3, 5, and 7 days while PaO2/FiO2 increased at 1 and 3 days (P < 0.05). APACHE-II and SOFA scores decreased in both groups at 3, 5, and 7 days (P < 0.05), whereas SOFA scores improved more in experimental group as compared with controls. Ventilator weaning time and ICU stay were significantly shorter in experimental group as compared with controls. In both groups, mean arterial pressure/systemic vascular resistance index post-treatment levels increased and lactic acid decreased at 6, 12, 24, 48, and 72 h (P < 0.05). Heart rate decreased at 24, 48, and 72 h (P < 0.05); while gamma-glutamyl transpeptidase and glutamate oxaloacetate transaminase levels increased at 1 day and 1 and 3 days, respectively (P < 0.05). Combined use of SFI and EGDT can improve hemodynamics, reduce the damage to vital organs, and shorten ventilation and ICU stay times in septic shock patients.