Effects of ulinastatin treatment on the cardiopulmonary bypass-induced hemodynamic instability and pulmonary dysfunction

• DOI: 10.1097/01.ccm.0000215110.55899.ae
• Publication Date: 2006-03-15T09:02:59Z
• Authors: Kazuhiro Nakanishi; Shinhiro Takeda; Atsuhiro Sakamoto; Akira Kitamura
• Keywords: Ulinastatin

To examine the association between decreased release of proinflammatory cytokines in response to urinary trypsin inhibitor pretreatment and myocardial lung injury after cardiopulmonary bypass.A prospective, randomized, double-blind study.University hospital.Thirty patients on bypass undergoing coronary artery grafting.Patients received 5000 units/kg intravenous (n = 15) or 0.9% saline (control, n immediately before aortic cannulation for bypass.Neutrophil elastase, tumor necrosis factor-alpha, interleukin-6, interleukin-8 were measured intubation (T1), (T2), separation from (T3), at end surgery (T4), postoperative days 1 (T5), 3 (T6), 5 (T7). Simultaneous hematocrit values obtained all sample times. Isoenzyme creatine kinase with muscle brain subunits, troponin-T, myosin light chain I also measured. Various hemodynamic pulmonary data perioperatively. Levels neutrophil elastase corrected hemodilution. Interleukin-6 levels lower T3 T4 group than control group. Stroke volume index was significantly T3, statistical difference found groups (p < .01). Respiratory intrapulmonary shunt higher T3. Changes respiratory correlated (r .52, p 00001; r .37, 0001, respectively) .44, .001; .24, .05, respectively). Neutrophil cardiac marker responses grafting similar both groups.Prepump administration attenuates elevation interleukin-6 bypass.