Effects of ulinastatin treatment on myocardial and renal injury in patients undergoing aortic valve replacement with cardiopulmonary bypass
Korean Journal of Anesthesiology 2012³â 62±Ç 2È£ p.148 ~ p.153
¿À¼¼¿ë(Oh Se-Young) - Yonsei University College of Medicine Department of Anesthesiology and Pain Medicine
±èÁ¾Âù(Kim Jong-Chan) - Kyungpook National University Hospital Department of Anesthesiology and Pain Medicine
ÃÖ¿ë¼±(Choi Yong-Seon) - Yonsei University College of Medicine Department of Anesthesiology and Pain Medicine
ÀÌ¿ì°æ(Lee Woo-Kyung) - Yonsei University College of Medicine Department of Anesthesiology and Pain Medicine
ÀÌ¿µ±Ô(Lee Yeong-Kyu) - Yonsei University College of Medicine Department of Anesthesiology and Pain Medicine
°û¿µ¶õ(Kwak Young-Lan) - Yonsei University College of Medicine Department of Anesthesiology and Pain Medicine
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.
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Cardiac surgical procedures, Cardiopulmonary bypass, Myocardiac protection
KMID :
0356920120620020148
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À¯È¿¼º°á°ú(Recomendation)
ulinastatin did not effectively reduce CBP-induced damage to the heart and kidneys of patients who underwent an aortic valve replacement. No significant differences in serum levels of CK-MB, creatinine, cystatin C, or NGAL were observed between the groups throughout the study period.