title: Effects of ulinastatin treatment on myocardial and renal injury in patients undergoing aortic valve replacement with cardiopulmonary bypass.
abstract: BACKGROUND
  We determined the protective effects of a high dose of ulinastatin on myocardial and renal function in patients undergoing aortic valve replacement with cardiopulmonary bypass (CPB).
  
  
  METHODS
  Sixty patients were assigned randomly to either the ulinastatin group (n = 30) or the control group (n = 30). In the ulinastatin group, ulinastatin (300,000 U) was given after the induction of anesthesia, ulinastatin (400,000 U) was added to the CPB pump prime, and then ulinastatin (300,000 U) was administered after weaning from CPB. In the control group, the same volume of saline was administered at the same time points. Creatine kinase-MB levels were assessed 1 day before surgery, and on the first and second postoperative day (POD 1 and 2). Serum creatinine and cystatin C levels were assessed 1 day before surgery, upon intensive care unit arrival, and on POD 1 and 2. The level of plasma neutrophil gelatinase-associated lipocalin was assessed before induction of anesthesia, upon ICU arrival, and on POD 1.
  
  
  RESULTS
  No significant differences were observed in serum levels of creatine kinase-MB and biomarkers of renal injury between the two groups at any point during the study period.
  
  
  CONCLUSIONS
  Ulinastatin showed no cardiac or renal protective effects after CPB in patients undergoing aortic valve replacement.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Se-Young
authors.initials: SY
authors.lastname: Oh
authors.forename: Jong Chan
authors.initials: JC
authors.lastname: Kim
authors.forename: Yong Seon
authors.initials: YS
authors.lastname: Choi
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Lee
authors.forename: Yeong-Kyu
authors.initials: YK
authors.lastname: Lee
authors.forename: Young Lan
authors.initials: YL
authors.lastname: Kwak