Xuebijing Injection Alleviates the Inflammatory Response in Patients with Venous-Arterial Extracorporeal Membrane Oxygenation: A Prospective Randomized Controlled Study

Zhiyong Yuan; Ying Liu; Fuhua Wang; Xiaoning Han; Zhenhui Dong; Jinyan Xing; Xiaotian Chang

doi:10.31083/j.rcm2511405

Xuebijing Injection Alleviates the Inflammatory Response in Patients with Venous-Arterial Extracorporeal Membrane Oxygenation: A Prospective Randomized Controlled Study

Rev Cardiovasc Med. 2024 Nov 19;25(11):405. doi: 10.31083/j.rcm2511405. eCollection 2024 Nov.

Authors

Zhiyong Yuan¹, Ying Liu¹, Fuhua Wang¹, Xiaoning Han¹, Zhenhui Dong¹, Jinyan Xing¹, Xiaotian Chang²

Affiliations

¹ Department of Critical Medicine, The Affiliated Hospital of Qingdao University, 266000 Qingdao, Shandong, China.
² Medical Research Center of the Affiliated Hospital of Qingdao University, 266000 Qingdao, Shandong, China.

Abstract

Background: Both acute myocardial infarction (AMI) and its salvage treatment, venoarterial-extracorporeal membrane oxygenation (VA-ECMO), may lead to the production of proinflammatory cytokines and further aggravate tissue damage. Xuebijing (XBJ) may modulate cytokine production involved in the inflammatory response. We aimed to determine the efficacy of XBJ in cardiogenic shock patients on VA-ECMO.

Methods: This was a prospective, randomized trial carried out in an intensive care unit of a tertiary teaching hospital. Patients with cardiogenic shock after acute myocardial infarction undergoing percutaneous coronary intervention (PCI) with VA-ECMO support were randomly divided into a Xuebijing group and a control group. Cytokines, inflammatory factors and left ventricular ejection fraction (LVEF) were compared between the groups.

Results: 41 patients were enrolled in the study, with 21 in the Xuebijing group and 20 in the control group. 28 (68.3%) were male, and the average age was 64.71 ± 8.18 years old. There was no difference in APACHEII (acute physiology and chronic health evaluation II) score, LVEF, or cytokine and inflammatory factors collected before extracorporeal membrane oxygenation (ECMO) between the two groups. The levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in the Xuebijing group were lower than those in the control group in the first 24 hours, 48 hours and 72 hours after ECMO (p < 0.05). The LVEF in the Xuebijing group was higher than that of the control group at 48 hours (31.57 ± 3.43 vs. 28.35 ± 4.42, p = 0.013). This trend persisted at 72 hours. The duration of ECMO support in the Xuebijing group was 5.57 ± 2.11 days, which was shorter than that in the control group (p = 0.033).

Conclusions: Xuebijing injection can reduce the inflammatory response and improve cardiac function in patients with acute myocardial infarction treated with VA-ECMO to a certain extent.

Clinical trial registration: Chinese Clinical Trial Registry (ChiCTR), ChiCTR2100054069, Registered 8, December 2021, https://www.chictr.org.cn/showproj.html?proj=142869.

Keywords: Xuebijing injection; acute myocardial infarction; cardiogenic shock; cytokine; inflammation storm; venous-arterial extracorporeal membrane oxygenation.