Journal of Chest Surgery

  • 제46권3호
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  • Pages.185-191
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  • 2013
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
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Effects of Ulinastatin on Postoperative Blood Loss and Hemostasis in Atrioventricular Valve Surgery with Cardiopulmonary Bypass

  • Park, Jae Bum (Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine) ;
  • Kim, Seong Hyop (Department of Anaesthesiology and Pain Medicine, Konkuk University School of Medicine) ;
  • Lee, Song Am (Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine) ;
  • Chung, Jin Woo (Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine) ;
  • Kim, Jun Seok (Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine) ;
  • Chee, Hyun Keun (Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine)
  • 투고 : 2012.10.15
  • 심사 : 2012.10.26
  • 발행 : 2013.06.05
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초록

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.

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참고문헌

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피인용 문헌

  1. Effect of Urinary Protease Inhibitor (Ulinastatin) on Cardiopulmonary Bypass: A Meta-Analysis for China and Japan vol.9, pp.12, 2014, https://doi.org/10.1371/journal.pone.0113973
  2. Lack of Efficacy of Ulinastatin Therapy During Cardiopulmonary Bypass Surgery vol.128, pp.23, 2013, https://doi.org/10.4103/0366-6999.170364
  3. Ulinastatin attenuates vascular endothelial cell damage in pregnant women with severe pre-eclampsia vol.91, pp.3, 2013, https://doi.org/10.1590/0001-3765201920180746
  4. Ulinastatin reduces postoperative bleeding and red blood cell transfusion in patients undergoing cardiac surgery : A PRISMA-compliant systematic review and meta-analysis vol.99, pp.7, 2013, https://doi.org/10.1097/md.0000000000019184
  5. Effect of ulinastatin on post-operative blood loss and allogeneic transfusion in patients receiving cardiac surgery with cardiopulmonary bypass: a prospective randomized controlled study with 10-year vol.15, pp.1, 2013, https://doi.org/10.1186/s13019-020-01144-9