Korean J Thorac Cardiovasc Surg.  2013 Jun;46(3):185-191. 10.5090/kjtcs.2013.46.3.185.

Effects of Ulinastatin on Postoperative Blood Loss and Hemostasis in Atrioventricular Valve Surgery with Cardiopulmonary Bypass

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine, Korea. cheehk@kuh.ac.kr
  • 2Department of Anaesthesiology and Pain Medicine, Konkuk University School of Medicine, Korea.

Abstract

BACKGROUND
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.
MATERIALS AND METHODS
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.
RESULTS
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.
CONCLUSION
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.

Keyword

Cardiopulmonary bypass; Polymorphonuclear neutrophils; Postoperative outcomes

MeSH Terms

Cardiopulmonary Bypass
Constriction
Glycoproteins
Heart
Hemostasis
Humans
Intensive Care Units
Intubation
Neutrophils
Postoperative Hemorrhage
Thoracic Surgery
Thoracotomy
Trypsin
Glycoproteins
Trypsin
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