The Clinical Evaluation On Adjuvant Therapy Of Xuebijing Injection To The PR-MODS Patients

Why the mortality of the cardiac arrest (CA) person who has got resumption of spontaneous circulation is high is related to PR-MODS (post-resuscitation multiple organ dysfunction syndrome) and how to therapy it becomes the difficulty in the region of CPR .There is no western drug is confirmed to be effective until now .Xuebijing injection is widely used in the therapy of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) which is caused by various kinds of critical illnesses these years because it can suppress inflammatory response and protect the function of multiple organs. The intervention of Xuebijing injection in the therapy of PR-MODS is lack and the outcome measures aren't enough so it can not reflect the influence of its function of protecting multiple organs and final prognosis. So we discuss the effect of Xuebijing injection to PR-MODS by several outcome measures.Objective: We discuss the function of Xuebijing injection in the therapy of PR-MODS by means of use it to patient who suffer from CA and ROSC as adjuvant therapy in order to discuss the clinical evaluation of Xuebijing injection to PR-MODS patients.Methods: We analyzed 42 cardiac arrest patients retrospectively who were successfully resuscitated and accompanied with MODS . Both of them were given comprehensive treatment including correct the cause, circulation support, mechanical ventilation, mild hypothermia, infection control and so on. They were divided into two groups, conventional therapy group and Xuebijing therapy group by whether they had used Xuebijing injection or not, and 20 of them used Xuebijing injection while 22 not. We collected total bilirubin(TBIL), creatinine (Cr),platelet ( Plt ), PaO2 of the two groups at the time of 24h, 48 h, 72h after the restoration of spontaneous circulation (ROSC) and the level of creatine kinase-MB (CK-MB )and lactic acid (Lac )at the time of restoration of spontaneous circulation (ROSC) and 24h,48 h,72h after ROSC. Conscious state , systolic blood pressure(SBP), melena and borborygmus of the two groups at the time of 24h, 48 h, 72h after ROSC were also collected, and we observed the time of mechanical ventilation and cerebral performance category (CPC). By comparing the score of multiple organ dysfunction syndrome with illness ,the level of CK-MB and Lac, CPC and the survival rate to find whether there were differences between the two groups.Results: 1. At the time of 24h after ROSC, the scores of the severity of MODS were high in the two groups while no significant differences was observed between them(P>0.05), the scores of the severity of MODS were on the rise at the time of 48h and 72h after ROSC in the two groups, while in the conventional therapy group the score of the severity of MODS was significant higher than in the Xuebijing therapy group at different time points(P<0.05). 2. At the time of ROSC the CK-MB level of the two groups both increased obviously, while no significant differences was observed between them(P>0.05), the level of CK-MB peaked at the time of 24h after ROSC and than decreased to the minimum at the time of 72h after ROSC, but the level of Lac was higher in the conventional therapy group than that in the Xuebijing therapy group at different time points (P<0.05). 3. Differences of CPC after discharge were not statistically significant in the two group(sP<0.05). 4. At the time of ROSC the level Lac of the two groups both increased obviously, while there was no significant differences between them(P>0.05), after treatment the level of Lac was higher in the conventional therapy group than in the Xuebijing therapy group and there was statistically significant differences between the two groups (P<0.05). 5.The survival rate between the two groups was not statistically significant(P>0.05).Conclusion: Using Xuebijing injection as adjuvant therapy to PR-MODS can improve the function of multiple organs, alleviate the heart injury obviously and improve tissue perfusion, the effect on neurological recovery and long-term prognosis require further investigation.