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Clinical Effect of Shenfu Injection in Patients with Septic Shock: A Meta-Analysis and Systematic Review.

Mou Z, Lv Z, Li Y, Wang M, Xu Q, Yu X - Evid Based Complement Alternat Med (2015)

Bottom Line: As the endpoint of mortality was not unified, it was not meta-analyzed.Conclusions.Based on the findings in present review, Shenfu injection is more effective than conventional therapy in increasing mean arterial pressure, normalizing heart rate, clearing serum lactate, and reducing mortality.

View Article: PubMed Central - PubMed

Affiliation: Emergency Department, Peking Union Medical College Hospital, Beijing 100730, China.

ABSTRACT
Purpose. To conduct a meta-analysis evaluating the efficacy of Shenfu injection for treating patients with septic shock when compared with conventional therapy. Methods. Eight databases including Pubmed, EMBASE, Cochrane Library, ISI Web of Science, CNKI, Wanfang, VIP, and CBM were searched up to October 2014. Randomized controlled trials assessing the efficacy of Shenfu injection were identified. Mean arterial pressure, heart rate, lactate, and mortality were included as outcome measurements. Results. We analyzed data from 12 randomized controlled trials involving 904 participants. Compared with conventional therapy, Shenfu injection could further increase the mean arterial pressure at 1 hour (SMD 0.38; 95% CI, 0.01-0.74) and 6 hours (SMD 0.82; 95% CI, 0.03-1.61). Shenfu injection could further normalize heart rate at 6 hours (SMD -0.90; 95% CI, -1.47-0.33) and clear serum lactate at 6 hours (SMD -0.51; 95% CI, -0.70-0.32) and 24 hours (SMD, 0.52; 95% CI, -0.77-0.26). As the endpoint of mortality was not unified, it was not meta-analyzed. Conclusions. Based on the findings in present review, Shenfu injection is more effective than conventional therapy in increasing mean arterial pressure, normalizing heart rate, clearing serum lactate, and reducing mortality. These results should be confirmed in higher level clinical trials in the future.

No MeSH data available.


Related in: MedlinePlus

Forest plot of Shenfu injection plus conventional therapy versus conventional therapy: lactate; the authors' judgment about each risk of bias item for each included study.
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fig4: Forest plot of Shenfu injection plus conventional therapy versus conventional therapy: lactate; the authors' judgment about each risk of bias item for each included study.

Mentions: The methodological quality of selected trials was assessed using the Cochrane Collaboration's tool. All of the studies included suggested randomization, but only five studies reported the method of random sequences generation. All studies failed to report details about allocation concealment. The blinding of outcome measurement was judged to low risk of bias because the outcomes were unlikely to be influenced by lack of blinding but there was high risk bias for blinding the participants or personnel in all studies. The number of dropouts and reasons for withdrawal were not reported in any of the above studies. When it comes to selective reporting bias, there was a low risk of bias since we only included the studies which used HR, MAP, lactate, or mortality as outcome measures. All studies had low risk of other biases except two studies that did not report baseline similarity. Finally, all studies were judged to be of a poor methodological quality. The judgment of risk of bias was presented in corresponding forest plots (Figures 2, 3, and 4).


Clinical Effect of Shenfu Injection in Patients with Septic Shock: A Meta-Analysis and Systematic Review.

Mou Z, Lv Z, Li Y, Wang M, Xu Q, Yu X - Evid Based Complement Alternat Med (2015)

Forest plot of Shenfu injection plus conventional therapy versus conventional therapy: lactate; the authors' judgment about each risk of bias item for each included study.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4496657&req=5

fig4: Forest plot of Shenfu injection plus conventional therapy versus conventional therapy: lactate; the authors' judgment about each risk of bias item for each included study.
Mentions: The methodological quality of selected trials was assessed using the Cochrane Collaboration's tool. All of the studies included suggested randomization, but only five studies reported the method of random sequences generation. All studies failed to report details about allocation concealment. The blinding of outcome measurement was judged to low risk of bias because the outcomes were unlikely to be influenced by lack of blinding but there was high risk bias for blinding the participants or personnel in all studies. The number of dropouts and reasons for withdrawal were not reported in any of the above studies. When it comes to selective reporting bias, there was a low risk of bias since we only included the studies which used HR, MAP, lactate, or mortality as outcome measures. All studies had low risk of other biases except two studies that did not report baseline similarity. Finally, all studies were judged to be of a poor methodological quality. The judgment of risk of bias was presented in corresponding forest plots (Figures 2, 3, and 4).

Bottom Line: As the endpoint of mortality was not unified, it was not meta-analyzed.Conclusions.Based on the findings in present review, Shenfu injection is more effective than conventional therapy in increasing mean arterial pressure, normalizing heart rate, clearing serum lactate, and reducing mortality.

View Article: PubMed Central - PubMed

Affiliation: Emergency Department, Peking Union Medical College Hospital, Beijing 100730, China.

ABSTRACT
Purpose. To conduct a meta-analysis evaluating the efficacy of Shenfu injection for treating patients with septic shock when compared with conventional therapy. Methods. Eight databases including Pubmed, EMBASE, Cochrane Library, ISI Web of Science, CNKI, Wanfang, VIP, and CBM were searched up to October 2014. Randomized controlled trials assessing the efficacy of Shenfu injection were identified. Mean arterial pressure, heart rate, lactate, and mortality were included as outcome measurements. Results. We analyzed data from 12 randomized controlled trials involving 904 participants. Compared with conventional therapy, Shenfu injection could further increase the mean arterial pressure at 1 hour (SMD 0.38; 95% CI, 0.01-0.74) and 6 hours (SMD 0.82; 95% CI, 0.03-1.61). Shenfu injection could further normalize heart rate at 6 hours (SMD -0.90; 95% CI, -1.47-0.33) and clear serum lactate at 6 hours (SMD -0.51; 95% CI, -0.70-0.32) and 24 hours (SMD, 0.52; 95% CI, -0.77-0.26). As the endpoint of mortality was not unified, it was not meta-analyzed. Conclusions. Based on the findings in present review, Shenfu injection is more effective than conventional therapy in increasing mean arterial pressure, normalizing heart rate, clearing serum lactate, and reducing mortality. These results should be confirmed in higher level clinical trials in the future.

No MeSH data available.


Related in: MedlinePlus