Protective effect of pituitrin combined with norepinephrine on cardiopulmonary injury in patients with septic shock diagnosed by critical care ultrasound evaluation

Pak J Pharm Sci. 2026 Mar;39(3):878-886. doi: 10.36721/PJPS.2026.39.3.REG.12881.1.

ABSTRACT

BACKGROUND: Septic shock is a life-threatening complication of sepsis, often accompanied by cardiopulmonary dysfunction, which significantly increases the mortality of patients. Norepinephrine (NE) is a commonly used vasopressor in the treatment of septic shock, but single-drug therapy may not fully achieve cardiopulmonary protection. Antidiuretic hormone (ADH) has potential regulatory effects on hemodynamics and inflammation, but its combined efficacy with NE in cardiopulmonary protection for septic patients remains to be further verified.

OBJECTIVES: This study aims to investigate the effectiveness of ADH combined with NE in providing cardiopulmonary protection for septic patients.

METHODS: A total of 100 patients with septic shock admitted to our hospital from March 2022 to March 2023 were enrolled in this study. They were randomly divided into an observation group and a control group, with 50 patients in each group. The observation group was treated with ADH combined with NE, while the control group received NE monotherapy. Relevant indicators of the two groups were dynamically monitored and compared.

RESULTS: Statistical analysis showed that tumor necrosis factor-α (TNF-α), cardiac troponin I (cTnI), and brain natriuretic peptide (BNP) had significant differences in group effect, time effect, and interaction effect (P<0.05). Interleukin-1 (IL-1) and interleukin-6 (IL-6) only showed significant time effect (P<0.05), but no significant group effect or interaction effect (P>0.05). Arterial partial pressure of oxygen (PaO₂) and PaO2/fraction of inspired oxygen (P/F ratio) exhibited significant time effect and group effect (P<0.05), but no significant interaction effect (P>0.05). After treatment (T3), compared with the control group, the observation group had significantly lower levels of TNF-α, IL-1, IL-6, cTnI, BNP, and creatine kinase isoenzyme MB (CK-MB) (P<0.05), and significantly higher PaO₂ and P/F ratio (P<0.05).

CONCLUSION: ADH combined with NE can effectively improve the inflammatory response, cardiac and pulmonary function indexes of septic patients, and exert significant cardiopulmonary protection effects. It is a viable and effective therapeutic strategy for septic patients.

PMID:41620916 | DOI:10.36721/PJPS.2026.39.3.REG.12881.1