Ginsenosides compound (shen-fu) attenuates gastrointestinal injury and inhibits inflammatory response after cardiopulmonary bypass in patients with congenital heart disease.
OBJECTIVE
This study was undertaken to demonstrate that gastrointestinal mucosal injury occurs during cardiopulmonary bypass in children, increasing systemic inflammatory responses, and to determine whether shen-fu injection (the major components of which are ginsenosides compound, extract of Panax ginseng shown to have antioxidant properties) could attenuate gastrointestinal mucosal injury and subsequent inflammatory responses.


METHODS
Twenty-four children undergoing heart surgery for congenital heart defects were randomly assigned to groups C (placebo control, n = 12) and G (1.35 mg/kg ginsenosides compound intravenously before and throughout the course of cardiopulmonary bypass, n = 12). Central venous blood samples were taken before cardiopulmonary bypass and at 60 and 120 minutes after aortic declamping (reperfusion). Gastric intramucosal pH was measured by perioperative tonometry. Plasma lipid peroxidation product malondialdehyde, myocardium-specific creatine kinase isoenzyme MB activity, diamine oxidase, lipopolysaccharide, and interleukin 6 were all measured.


RESULTS
Significant decrease in gastric intramucosal pH and increase in plasma diamine oxidase were seen during reperfusion in group C, accompanied by increases in plasma levels of malondialdehyde, lipopolysaccharide, interleukin 6, and creatine kinase isoenzyme MB (P < .01 vs before cardiopulmonary bypass). Shen-fu injection significantly attenuated these changes (P < .05). Consequently, fewer patients in group G (2/12) than in group C (7/12) needed postoperative inotropic support. Postoperative intensive care unit stay was shorter in group G than in group C. A tight positive correlation was seen between diamine oxidase and interleukin 6 at 60 minutes after aortic declamping and between diamine oxidase and lipopolysaccharide at 120 minutes after aortic declamping (r = 0.79, P < .0001).


CONCLUSIONS
Ginsenosides compound may attenuate gastrointestinal injury and inhibit inflammatory response after cardiopulmonary bypass in patients with congenital heart disease.
Xia
Zhong-yuan
ZY
Anesthesiology Research Laboratory, Renmin Hosital, Wuhan University, People's Republic of China.
Liu
Xian-yi
XY
Zhan
Li-ying
LY
He
Yi-hong
YH
Luo
Tao
T
Xia
Zhengyuan
Z
D000293:Adolescent; D006631:Amine Oxidase (Copper-Containing) / Q000097:blood; D000975:Antioxidants / Q000494:pharmacology / Q000627:therapeutic use*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002648:Child; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form; D004311:Double-Blind Method; D004365:Drugs, Chinese Herbal / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects; D005765:Gastrointestinal Agents / Q000494:pharmacology / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D006330:Heart Defects, Congenital / Q000097:blood / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D015850:Interleukin-6 / Q000097:blood; D007527:Isoenzymes / Q000097:blood; D008070:Lipopolysaccharides / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000097:blood
D000975:Antioxidants; D004365:Drugs, Chinese Herbal; D005765:Gastrointestinal Agents; D015850:Interleukin-6; D007527:Isoenzymes; D008070:Lipopolysaccharides; C492793:Shen-Fu; D008315:Malondialdehyde; D006631:Amine Oxidase (Copper-Containing); D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form