Non inferiority trial of Channa striata extract on endothelial glycocalyx layer protection in septic patient: a prospective cohort study

Abstract

Introduction: Sepsis causes significant damage to the endothelial glycocalyx layer, which albumin can protect against. Unfortunately, human albumin is quite expensive, so cheaper substitutes must be found without sacrificing effectiveness. Albumin extract Channa striata is one that is commonly used in Indonesia. Objectives: Conducted a non-inferiority study between human albumin and Channa striata extract in protecting the glycocalyx layer through syndecan-1 levels. Materials and methods: Prospective cohort study of adult patients with early sepsis with hypoalbuminemia (<4 g/dL) treated at ICU Dr Moewardi Hospital between May and October 2021 and got human albumin or Channa striata extract as therapy. The Channa striata group was oberved in two separated groups. The control groups with human albumin 20% 100 ml single dose and the Channa striata group with 15 gram extract of Channa striata in two days, then syndecan-1 levels were compared before treatment and on the third day of the study. Results: We discovered a statistically significant decrease in syndecan-1 levels in both the study (p = 0.013) and control groups (p = 0.027) from the 44 samples we obtained. Conclusion: In both groups, we found a significant decrease in syndecan-1 levels. This demonstrates that Channa striata extract is not inferior to human albumin in terms of glycocalyx layer protection. And it has a higher economic value because the price is lower.

The Efficacy of Channa Striata Extract Administration in Improving Albumin and Creatinine Levels in Sepsis Patients in the Intensive Care Unit

“…Meanwhile, the use of CS extract in other critical diseases (e.g., stroke) may increase albumin levels after CS supplementation (Kasim et al, 2017). In this study, patients with sepsis received CS supplements for five days (Permana et al, 2023). In another study, five-day CS supplementation accelerated healing processes and wound inflammation after the surgery.…”

“…It turned out that there was no significant difference between the two in stabilizing PAI-1 in sepsis patients (p = 0,503). In addition, platelet differences between the CS group and human albumin were not significant differences (p = 0.187) (Permana et al, 2023) then conducted a follow-up study in 2023 with the same treatment group with administration for two days to see the effect on syndecan-1. It was found that there was a decrease in syndecan-1 in the CS group (p = 0.013) and human albumin (p = 0.027), so it was concluded that there was no significant difference between the two.…”

“…This is in line with the study of Thamrin and Rusman (2021), who found that the administration of CS extract in patients undergoing radiotherapy had no significant effect on changes in albumin, urea, and creatinine. Another study found no significant difference between administering human albumin and CS albumin to sepsis patients in intensive care units because CS extracts are considered reliable and cost-effective for patients (Permana et al, 2023). This is due to Branched Chain Amino Acids (BCAA) content and the ketogenic amino acids contained in CS, which can prevent impaired kidney function characterized by increased creatinine levels (Palupi et al, 2015).…”