title: Continuous infusion of high-dose ulinastatin during surgery does not improve early postoperative clinical outcomes in patients undergoing radical lung cancer surgery: A pilot study.
abstract: BACKGROUND
  Ulinastatin can prevent the perioperative increase in proinflammatory cytokines for lung resection surgery; however, its impact on early clinical outcomes remains unknown.
  
  
  METHODS
  The study enrolled 108 non-small cell lung cancer (NSCLC) patients who were randomly allocated into two groups: ulinastatin (group U) and control (group C). Patients in group U ( n = 52) were continuously intravenously infused with ulinastatin at a rate of 20 000 U/kg/hour for the first hour after anesthesia induction, and then at a rate of 5000 U/kg/hour until the conclusion of surgery. Patients in group C ( n = 56) received an equivalent volume of normal saline. The primary outcome was to record the postoperative pulmonary complications that occurred during hospital stay. Other clinical courses, such as hospital mortality, blood loss, respiratory parameters, postoperative chest drainage, and duration of intensive care unit and postoperative hospital stay, were also observed and analyzed.
  
  
  RESULTS
  There were no significant differences between the two groups in early postoperative pulmonary complications, hospital mortality, blood loss, or other perioperative laboratory values, except for the duration of postoperative chest drainage and serum creatinine level. The frequency of pulmonary complications was lower in patients treated with ulinastatin compared with the control (38.46% in group U vs. 48.21% in group C).
  
  
  CONCLUSIONS
  Administration of high-dose ulinastatin during surgery did not reduce postoperative pulmonary complications, hospital mortality, or hospital stay for patients undergoing lung radical thoracotomy. However, a protective trend of ulinastatin was observed.
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Leng
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Haidan
authors.initials: H
authors.lastname: Lan
authors.affiliation: The Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: The Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Xiao Jun
authors.initials: XJ
authors.lastname: Tang
authors.affiliation: The Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Daxing
authors.initials: D
authors.lastname: Zhu
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Jianming
authors.initials: J
authors.lastname: Yue
authors.affiliation: Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D016207:Cytokines / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006023:Glycoproteins / Q000008:administration & dosage* / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D011184:Postoperative Period; D013510:Pulmonary Surgical Procedures / Q000379:methods; D014361:Trypsin Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D016207:Cytokines; D006023:Glycoproteins; D014361:Trypsin Inhibitors; C028665:urinastatin
keywords: Non-small cell lung cancer; postoperative pulmonary complications; thoracotomy; ulinastatin