Evaluating the therapeutic effects of creatine phosphate administration in sepsis-induced myocardial dysfunction

The objective of this study is to investigate the involvement of creatine phosphate (CP) in sepsis-induced myocardial dysfunction (SIMD) among patients. A retrospective analysis was conducted to gather data on patients with SIMD. Based on the administration of CP, the patients were categorized into 2 groups: the observation group and the control group. The study recorded fundamental demographic information including age, gender, and factors contributing to infection, as well as various clinical indices. Additionally, measurements of vasoactive infusion score (VIS), lactate, N-terminal pro-B-type natriuretic peptide (NT-proBNP), cardiac troponin-I (cTnI), central venous-arterial CO2 gap (GAP), and central venous-arterial CO2 gap to arterial-central venous O2 content difference ratio (Pv-aCO2/Ca-vO2) (GAP ratio) were taken before treatment, as well as at 24-hour and 72-hour intervals post-treatment. Furthermore, the study documented the patients' 28-day survival rate, tracheal intubation extubation rate, duration of mechanical ventilation, length of stay in the intensive care unit (ICU), and overall length of hospitalization. A total of 572 patients were ultimately selected for inclusion in the study, with 299 cases assigned to the observation group and 273 cases assigned to the control group. No statistically significant differences were observed between the 2 groups in terms of age, gender, cause of infection, body mass index, cardiac index, Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation II, and premedication clinical indices. After 24 hours of treatment, there were no statistically significant differences between the 2 groups in VIS, lactic acid, cTnI, and GAP ratio, but significant differences were observed in NT-proBNP and GAP. At the 72-hour mark following treatment, the observation group exhibited superior results in VIS, lactate, NT-proBNP, GAP, and GAP ratio compared to the control group. However, there was no statistically significant difference in cTnI levels. Furthermore, the observation group demonstrated significant improvements in the 28-day survival rate, tracheal intubation extubation rate, mechanical ventilation, and ICU stay time, and 28-day all-cause mortality risk Kaplan-Meier curve when compared to the control group. The sustained administration of CP for a duration exceeding 3 days has been observed to enhance the oxygen delivery and systemic perfusion in patients with SIMD, leading to improved cardiac function and cardioprotection. Additionally, this intervention has demonstrated the potential to enhance the patient's 28-day survival rate, tracheal intubation extubation rate, while reducing the need for mechanical ventilation and length of stay in ICU.