Effect of anisodamine hydrobromide on improving early microcirculation disturbance in septic shock patients

BACKGROUND Septic shock, prevalent in critical care medicine, poses significant treatment challenges and high mortality rates. Its pathogenesis involves an inflammatory cytokine storm and microcirculatory dysfunction, potentially leading to fatal multiple organ failure. Microcirculation alterations during septic shock critically impact patient outcomes. Anisodamine hydrobromide, a commonly used anticholinergic, mitigates oxidative stress and modulates cell apoptosis, notably enhancing microcirculation by targeting cholinergic receptors. This study investigates the efficacy of anisodamine hydrobromide in ameliorating microcirculatory disorders in septic shock patients. Methods This article collects 72 cases of patients with septic shock from the Department of Critical Care Medicine, Affiliated Hospital of Hebei University from 2020 to 2024. Participants were assigned to either a treatment group or a control group based on the administration of anisodamine hydrobromide. Data on heart rate, mean arterial pressure (MAP), blood lactate (LAC) levels, peripheral blood perfusion index (PI), and mottling scores were collected at 0, 6, 24, and 48 hours post-admission. Additionally, the 28-day mortality rate and progression from acral cyanosis to acral necrosis were assessed. Statistical analysis was conducted to compare differences in these indices between the groups. Results No statistically significant difference was observed in 28-day mortality between the treatment and control groups (14% vs. 16%; p = 0.86). Norepinephrine dosage also showed no significant difference. Heart rates at 6 and 24 hours post-treatment were statistically similar; however, at 48 hours, the treatment group exhibited a significantly lower heart rate than the control group. ScvO2 and Pcv-aCO2 levels did not differ significantly between groups at any time point (all p > 0.05). Comparison of microcirculatory oxygen metabolism indicators between the groups: The treatment group exhibited significant improvements in lactate and PI compared to the control group (P <0.05). At 6 and 24 hours post-treatment, the SMS scores were lower in the treatment group, though no significant difference was observed at 48 hours. CRT showed no difference at 6 hours, but the treatment group demonstrated significant improvement at 24 and 48 hours (P > 0.05). No statistically significant difference was found in the progression from acral cyanosis to acral necrosis between the groups. Conclusion The standardized treatment of septic shock, when combined with anisodamine hydrobromide infusion, enhances early microcirculation indicators in septic shock patients.