Effect of phentolamine adjuvant therapy on hemodynamics and cardiac function in patients with septic myocardial injury

Purpose: To investigate the effect of phentolamine adjuvant therapy on hemodynamics and cardiac function in patients with sepsis-induced myocardial injury. Methods: A total of 96 patients with sepsis-induced myocardial injury between January 2019 and October 2023 admitted in Hangzhou Fuchun Traditional Chinese Orthopedic Hospital, Hangzhou, Zhejiang, China were randomly and equally assigned to control and study groups. The control group received routine treatment while the study group received phentolamine 5 mg/h for 24 h in addition to routine treatment. Blood lactate levels before and after treatment were compared. Intrathoracic blood volume index (ITBVI), systemic vascular resistance index (SVRI), heart rate (HR), mean arterial pressure (MAP), cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP), as well as cardiac index (CI), left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD), and left ventricular end-diastolic diameter (LVEDD), were also evaluated before and after treatment. Furthermore, 28-day survival rates and intensive care unit (ICU) stay time were compared. Results: The study group showed significantly lower blood lactate levels at 12, 48, and 72 h after treatment compared to control group (p < 0.05). The study group showed significantly higher levels of MAP, ITBVI, SVRI, CI, and LVEF; and significantly lower levels of HR, LVESD, LVEDD, cTnI, and NT-proBNP after 7 days than the control group (p < 0.05). No deaths occurred within 7 days after treatment in either group. However, the study group exhibited significantly lower ICU stay time and 28-day mortality than the control group (p < 0.05). Conclusions: Phentolamine adjuvant therapy significantly improves hemodynamics, enhances cardiac function, mitigates myocardial injury, and restores blood lactate levels in patients with sepsis-induced myocardial injury. Longer follow-up would be necessary to evaluate long-term effect and potential complications of phentolamine-adjuvant therapy.