title: Ulinastatin improved cardiac dysfunction after cardiac arrest in New Zealand rabbits.
abstract: OBJECTIVE
  The present study was designed to evaluate the effects of ulinastatin (UTI) on cardiac dysfunction after cardiopulmonary resuscitation (CPR).
  
  
  METHODS
  A total of 48 healthy adult male New Zealand rabbits were untreated for 8 minutes after the induction of ventricular fibrillation (VF) by an external transthoracic alternating current and then treated by CPR. These rabbits were then randomly divided into the control and UTI groups after the return of spontaneous circulation (ROSC) and were observed for 8 hours after the ROSC. Before CPR and after ROSC at 2, 4, and 8 hours, blood samples were collected to determine the levels of tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), malondialdehyde (MDA), cardiac troponin I (cTnI), and N-terminal probrain natriuretic peptide (NT-proBNP), and the left ventricular ejection fraction (EF) was measured by echocardiography.
  
  
  RESULTS
  Nineteen of 24 rabbits in the control group and 18 of 24 in the UTI group were successfully resuscitated. The plasma levels of TNF-α, IL-6, MDA, cTnI, and NT-proBNP were significantly increased, accompanying a deceased EF in the control group, but the cotreatment with UTI decreased the plasma levels of TNF-α, IL-6, MDA, cTnI, and NT-proBNP (P < .05), attenuating the myocardial injury and improving the EF in the UTI group. Only 9 of 19 animals in the control group but 14 of 18 animals in the UTI group survived longer than 8 hours (P = .011).
  
  
  CONCLUSIONS
  The progression of proinflammatory responses, oxidative stress, and myocardial injury have been linked to the reduced EF after VF/CPR, and the administration of UTI at a cardioprotective dosage preserved the cardiac function after VF/CPR.
authors.affiliation: Department of Emergency Medicine, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Chun Lin
authors.initials: CL
authors.lastname: Hu
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.forename: Jin Ming
authors.initials: JM
authors.lastname: Xia
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Zeng
authors.forename: Xiao Xing
authors.initials: XX
authors.lastname: Liao
authors.forename: Hong
authors.initials: H
authors.lastname: Zhan
authors.forename: Xiao Li
authors.initials: XL
authors.lastname: Jing
authors.forename: Gang
authors.initials: G
authors.lastname: Dai
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D001784:Blood Gas Analysis; D016887:Cardiopulmonary Resuscitation; D006023:Glycoproteins / Q000494:pharmacology / Q000627:therapeutic use*; D006323:Heart Arrest / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000628:therapy; D053208:Kaplan-Meier Estimate; D008297:Male; D020011:Protective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D011817:Rabbits; D011897:Random Allocation; D013318:Stroke Volume / Q000187:drug effects; D016896:Treatment Outcome; D014361:Trypsin Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D014463:Ultrasonography; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D015415:Biomarkers; D006023:Glycoproteins; D020011:Protective Agents; D014361:Trypsin Inhibitors; C028665:urinastatin