Park Jae Bum, Kim Seong Hyop, Lee Song Am, Chung Jin Woo, Kim Jun Seok, Chee Hyun Keun
Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine, Korea.
Korean J Thorac Cardiovasc Surg. 2013 Jun;46(3):185-91. doi: 10.5090/kjtcs.2013.46.3.185. Epub 2013 Jun 5.
Cardiopulmonary bypass (CPB) induces variable systemic inflammatory reactions associated with major organ dysfunction via polymorphonuclear neutrophils (PMNs). Ulinastatin, a urinary trypsin inhibitor, inhibits PMN activity and reduces systemic inflammatory responses. The aim of this study is to evaluate the effect of ulinastatin on postoperative blood loss and laboratory changes in patients undergoing open heart surgery.
Between January 2008 and February 2009, 110 patients who underwent atrioventricular valve surgery through right thoracotomy were divided into two groups. Patients received either 5,000 U/kg ulinastatin (ulinastatin group, n=41) or the equivalent volume of normal saline (control group, n=69) before aortic cross clamping. The primary end points were early coagulation profile changes, postoperative blood loss, transfusion requirements, and duration of intubation and intensive care unit stay.
There were no statistically significant differences between the two groups in early coagulation profile, other perioperative laboratory data, and postoperative blood loss with transfusion requirements.
Administration of ulinastatin during operation did not improve the early coagulation profile, postoperative blood loss, or transfusion requirements of patients undergoing open heart surgery. In addition, no significant effect of ulinastatin was observed in major organs dysfunction, systemic inflammatory reactions, or other postoperative profiles.
体外循环（CPB）通过多形核中性粒细胞（PMN）引发与主要器官功能障碍相关的全身性炎症反应。乌司他丁是一种尿胰蛋白酶抑制剂，可抑制PMN活性并减轻全身性炎症反应。本研究旨在评估乌司他丁对心脏直视手术患者术后失血及实验室指标变化的影响。
2008年1月至2009年2月期间，110例行右胸切口房室瓣膜手术的患者被分为两组。在主动脉阻断前，患者分别接受5000 U/kg乌司他丁（乌司他丁组，n = 41）或等量生理盐水（对照组，n = 69）。主要终点为早期凝血指标变化、术后失血量、输血需求以及插管和重症监护病房停留时间。
两组在早期凝血指标、其他围手术期实验室数据以及术后失血量和输血需求方面无统计学显著差异。
手术期间给予乌司他丁并不能改善心脏直视手术患者的早期凝血指标、术后失血量或输血需求。此外，未观察到乌司他丁对主要器官功能障碍、全身性炎症反应或其他术后指标有显著影响。
