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Shenfu Injection Improves Arterial Vascular Reactivity

Phase 2
Conditions
Shenfu
Vascular Reactivity
Septic Shock
Interventions
Drug: shenfu injection
Registration Number
NCT03749525
Lead Sponsor
Jianfeng Xie
Brief Summary

Septic shock is a common and critical illness in ICU.The vascular dysfunction of septic shock is manifested by vasospasm and decreased arterial vascular reactivity . Current studies have shown that the main mechanisms of vasospasm and decreased arterial vascular reactivity include increased vasospasm and down-regulation of receptor sensitivity , and eventually cause a decrease in vascular smooth muscle contractility.A large number of vasodilators are released during septic shock, in which inducible nitric oxide synthase (iNOS) and prostacyclin (PGI2) are important vasodilators leading to septic shock vasospasm.At present, vasoactive drugs are widely used in clinically to improve vascular tone and are important means of circulation support. However, when the infection is heavier, the reactivity of the blood vessels to the vasoactive drugs is lowered, and it is difficult for the large doses of the vasoactive drugs to maintain the circulation stability. At this time, the use of vasoactive drugs alone does not benefit patients with septic shock and may require the combination of other drugs.From the perspective of Chinese medicine, shock is a disease of yang. Shenfu injection has the effect of rejuvenating the yang and replenishing the qi. This trial was designed to give patients with septic shock the use of Shenfu injection to determine the specific effects of Shenfu injection on vascular reactivity in patients with septic shock.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
26
Inclusion Criteria
  1. diagnosed as septic shock according to 2016 SSC Guidelines;
  2. The dose of norepinephrine required to maintain MAP>65mmHg ≥0.5μg/kg.min;
  3. SVRI <800 dyns/cm5.m2;
  4. CI>2.5L/min/m2;
  5. The patient or the patient's family signed the informed consent form for this trial.
Exclusion Criteria
  1. septic shock occurs more than 24 hours;
  2. Age > 85 years old or <18 years old;
  3. pregnant or lactating women;
  4. There are shock patients caused by other causes such as cardiogenicity and neurogenicity;
  5. The terminal state of malignant tumor end-stage disease or the patient who is expected to die within 24 hours.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
control groupshenfu injectionshenfu injection
placebo groupshenfu injection5% GS solution
Primary Outcome Measures
NameTimeMethod
The change of peripheral vascular resistanceday 0(before shenfu injection is used), day 3 (after shenfu injection is used for 72 hours)

Peripheral vascular resistance will be measured by PiCCO or Swan-Ganz and the change between day 0 and day 3

Secondary Outcome Measures
NameTimeMethod
Diastolic blood pressureday 1, day 2, day 3

We will measure blood pressure every hour and diastolic blood pressure will be recorded per hour.

Dosage of vasoactive drugsday 1, day 2,day 3

dosages of noradrenaline, adrenaline or any other kinds of vasoactive drugs

4/5000 dosages of adrenaline and norepinephrine

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