title: The effect of ulinastatin on postoperative blood loss in patients undergoing open heart surgery with cardiopulmonary bypass.
abstract: This prospective, randomized, double-blind study evaluated the effect of ulinastatin on postoperative blood loss and transfusion requirements of patients undergoing open-heart surgery with cardiopulmonary bypass (CPB) and aortic cross-clamping (ACC). CPB and ACC produce variable systemic  inflammatory reactions that are associated with multiorgan dysfunction via leucocytes, especially polymorphonuclear neutrophils (PMNs). PMNs increase blood loss and transfusion requirements. Ulinastatin, a urinary trypsin inhibitor, inhibits PMN activity and reduces the systemic inflammatory  response. Patients received either 5000 U/kg ulinastatin or the equivalent volume of normal saline (control group) before ACC. Postoperative blood loss and transfusion requirements were recorded. Duration of intubation and length of stay in the intensive care unit (ICU) were also noted. There  were no statistically significant between-group differences in postoperative blood loss and transfusion requirements. Ulinastatin caused a non-significant decrease in duration of intubation. Patients who received ulinastatin had significantly shorter ICU stays than control patients.
authors: Department of Anaesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors: J E
authors: JE
authors: Song
authors: W S
authors: WS
authors: Kang
authors: D K
authors: DK
authors: Kim
authors: T G
authors: TG
authors: Yoon
authors: T Y
authors: TY
authors: Kim
authors: Y-S
authors: YS
authors: Bang
authors: S H
authors: SH
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D016022:Case-Control Studies; D004311:Double-Blind Method; D005260:Female; D006023:Glycoproteins / Q000627:therapeutic use*; D006331:Heart Diseases / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D019106:Postoperative Hemorrhage / Q000188:drug therapy* / Q000209:etiology*; D011379:Prognosis; D011446:Prospective Studies; D014361:Trypsin Inhibitors / Q000627:therapeutic use
chemical_list: D006023:Glycoproteins; D014361:Trypsin Inhibitors; C028665:urinastatin