title: Effects of ulinastatin on postoperative blood loss and hemostasis in atrioventricular valve surgery with cardiopulmonary bypass.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Konkuk University School of Medicine, Korea.
authors.forename: Jae Bum
authors.initials: JB
authors.lastname: Park
authors.forename: Seong Hyop
authors.initials: SH
authors.lastname: Kim
authors.forename: Song Am
authors.initials: SA
authors.lastname: Lee
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Chung
authors.forename: Jun Seok
authors.initials: JS
authors.lastname: Kim
authors.forename: Hyun Keun
authors.initials: HK
authors.lastname: Chee
keywords: Cardiopulmonary bypass; Polymorphonuclear neutrophils; Postoperative outcomes