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.