Effect of Two Administration Routes of Shenmai Injection(参麦注射液)on Pulmonary Gas Exchange Function after Tourniquet-Induced Ischemia-Reperfusion

Objective:To compare the effect between nebulized and intravenous administration of Shenmai Injection（参麦注射液） on pulmonary gas exchange function of patients following tourniquet-induced lower limb ischemia-reperfusion.Methods:Thirty-eight patients scheduled for lower extremity surgery were randomized...

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Published in:Chinese journal of integrative medicine 2017, Vol.23 (1), p.18-24
Main Authors: Jin, Jian-guo, Shen, Hai-jian, Shan, Yuan-lu, Chen, Lei, Zhao, Xi-yue, Wang, Liang-rong, Lin, Li-na
Format: Article
Language:English
Subjects:
Adult
Blood Gas Analysis
Clinical Experience
Drug Administration Routes
Drug Combinations
Drugs, Chinese Herbal - administration & dosage
Drugs, Chinese Herbal - pharmacology
Drugs, Chinese Herbal - therapeutic use
Female
Humans
Injections
Interleukin-6 - blood
Interleukin-8 - blood
Male
Malondialdehyde - blood
Medicine
Medicine & Public Health
Pulmonary Gas Exchange - drug effects
Reperfusion Injury - blood
Reperfusion Injury - drug therapy
Reperfusion Injury - physiopathology
Tourniquets - adverse effects
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Summary:Objective:To compare the effect between nebulized and intravenous administration of Shenmai Injection（参麦注射液） on pulmonary gas exchange function of patients following tourniquet-induced lower limb ischemia-reperfusion.Methods:Thirty-eight patients scheduled for lower extremity surgery were randomized into three groups using the closed envelop method:Shenmai Injection was administered 30 min before tourniquet inflation by nebulization[0.6 mL/kg in 10 mL normal saline（NS）]in the nebulization group or by intravenous drip（0.6 mL/kg dissolved in 250 mL of 10%glucose） in the intravenous drip group,and equal volume of NS was given intravenously in the NS group;15 in each group.Arterial blood gases were analyzed,serum levels of malonaldehyde（MDA） and interleukine-6（IL-6） and interleukine-8（IL-8） were determined using the method of thiobarbituric acid reaction and enzyme-linked immuno sorbent assay respectively just before tourniquet inflation（TO）,and at 0.5 h（T1）,2 h（T2）,6 h（T3） after tourniquet deflation.Results:Compared with baselines at TO,MDA levels significantly increased at T2,T3 in the NS group and at T3 in the nebulization group,and IL-6 and IL-8 levels were significantly increased at T2,T3 in NS,the intravenous drip and the nebulization groups（P<0.05）.Arterial pressure of oxygen（PaO2） at T3 was decreased,while alveolararterial oxygen tension showed difference（PA-aDO2） at T3 in the NS group;RI at T3 in both intravenous drip and the nebulization groups were enhanced（P<0.05）.Compared with the NS group,MDA and IL-8levels at T2,T3,IL-6 at T3 in the intravenous drip group,and IL-8 at T3 in the nebulization group were all remarkably increased（P<0.05）.Additionally,MDA level at T3 in the nebulization group was higher than that in the intravenous drip group（P<0.05）.Conclusions:Intravenous administration of Shenmai Injection provided a better protective effect than nebulization in mitigating pulmonary gas exchange dysfunction in patients following tourniquet-induced limb ischemia-reperfusion.
ISSN:1672-0415
1993-0402
DOI:10.1007/s11655-016-2475-4