title: Lack of Efficacy of Ulinastatin Therapy During Cardiopulmonary Bypass Surgery.
abstract: BACKGROUND
  It was believed that inflammatory response induced by cardiopulmonary bypass (CPB) was blamed for complications after cardiac surgery. To improve the outcome, many pharmacological interventions have been applied to attenuate inflammatory response during CPB. The objective of this study was to investigate the effect of ulinastatin (urinary trypsin inhibitor [UTI]) on outcome after CPB surgery.
  
  
  METHODS
  Totally, 208 patients undergoing elective valves replacement between November 2013 and September 2014 were divided into Group U (n = 70) and Group C (n = 138) based on they received UTI or not. Categorical variables were compared between groups using Fisher's exact test, and continuous variables using unpaired Student's t-test or Mann-Whitney U-test. One-way analysis of variance and Dunnett's or Tukey's tests were used to compare values at different time points within the same group. The risk of outcomes was estimated and adjusted by multivariable logistic regression, propensity scoring, and mixed-effect models for all measured variables.
  
  
  RESULTS
  Both the serious complications in total, including death, acute lung injury, acute respiratory distress syndrome and acute kidney injury, and the other complications, including hemodialysis, infection, re-incubation, and tracheotomy were similar between the two groups (P > 0.05). After adjusted by multivariable logistic regression and the propensity score, UTI still cannot be found any benefit to improve any outcomes after cardiac surgery. Also, no statistical differences with regard to duration of postoperative mechanical ventilation, the length of Intensive Care Unit and hospital stays (P > 0.05).
  
  
  CONCLUSIONS
  UTI did not improve postoperative outcomes in our patients after cardiopulmonary bypass surgery.
authors.forename: Yan
authors.initials: Y
authors.lastname: Qiu
authors.forename: Jing
authors.initials: J
authors.lastname: Lin
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.forename: Jing
authors.initials: J
authors.lastname: Zhou
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Gong
authors.forename: Zhen
authors.initials: Z
authors.lastname: Qin
authors.affiliation: Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Du
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D005260:Female; D006023:Glycoproteins / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012128:Respiratory Distress Syndrome / Q000209:etiology; D012189:Retrospective Studies
chemical_list: D006023:Glycoproteins; C028665:urinastatin