Ulinastatin Alleviates Lung Injury during Cardopulmonary Bypass in Patients Underwent Valve Replacement Surgery_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

YU Xiangyou , FAN Lili.

Intensive Care Unit, The First Affiliated Hospital to Xinjiang Medical University. Urumchi, Xinjiang, 830054, ChinaCorresponding Author: YUXiang-you, E-mail: yu2796@ 163. com;

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Keywords：

Cardiopulmonary bypass; Ulinastatin; Lung injury

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Objective To study the protective effects of ulinastatin( UTI) on lung function after cardiopulmonary bypass( CPB) . Methods 42 Patients, ASA score Ⅱ ～Ⅲ, scheduled for elective cardiac valve replacement, were randomly allocated into three groups, ie. a control group, a low dose UTI group( UTI 8000U/kg) , and a high dose UTI group( UTI 12 000 U/kg) . Inspiratory pressure( PIP) , Plateau pressure ( Pplat) , alveolar-arterial oxygen pressure difference ( AaDO2 ) , static lung compliance ( Cs) and dynamic lung compliance ( Cd) were recorded before operation ( T1 ) and at 1 hour ( T2 ) , 4 hours ( T3 ) , 24 hours ( T4 ) after CPB termination. Results Compared with pre-CPB, postoperative PIP, Pplat and AaDO2 increased, and Cs and Cd decreased significantly in the control group( all P lt; 0. 05) . Compared with the control group at T2 ～T3 , postoperative PIP, Pplat, AaDO2 were significantly lower( P lt;0. 05) , and Cs and Cd were significantly higher in the two UTI groups( P lt;0. 05) . Compared with the low dose UTI group at T2 ～T3 , the PIP, Pplat and AaDO2 were significantly reduced( P lt;0. 05) , and the Cs and Cd were significantly increased in the high dose UTI group( P lt; 0. 05) . Conclusion UTI can alleviate lung injury and improve lung function during valve replacement surgery with CPB in a dose dependent manner.

Citation： YU Xiangyou,FAN Lili.. Ulinastatin Alleviates Lung Injury during Cardopulmonary Bypass in Patients Underwent Valve Replacement Surgery. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(2): 154-158. doi: Copy

1.	Ng CS,Wan S, Yim AP, et al. Pulmonary dysfunction after cardiac surgery. Chest, 2002 , 121: 1269-1277.
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7.	Nakanishi K, Takeda S, Sakamoto A, et al. Effects of ulinastatin treatement on the cadliopulmonary byass- induced hemodynamic instability and pulmonary dysfunction. Cirt Care Med, 2006, 34 :1351-1357.
8.	Masaaki U, Satoshi T, Kousuke C, et al. Urinary Trypsin inhibitor reduces inflammatory response in kidney induced by lipopolysaccharide. J Biosci Bioeng, 2007, 104: 315 -320.
9.	刘虹, 安友仲, 李芳芳, 等. 乌司他丁对脂多糖诱导大鼠急性肺损伤作用的研究. 中国呼吸与危重监护杂志, 2008, 7: 290-293.
10.	姜兴权, 王育珊, 王爽骥, 等. 急性肺损伤肺保护性通气乌司他丁干预的临床研究. 中国急救医学, 2006 , 26: 161-163.
11.	陈聪, 李伦明, 曹明娟, 等. 乌司他丁在体外循环中对肺保护作用的临床研究. 中国心血管病研究杂志, 2007, 5 : 109-112.
12.	李汝勇, 张继红, 李玉芝. 乌司他丁对急性肺损伤机械通气患者肺保护的临床研究. 中国危重病急救医学, 2008, 20: 373-374.
13.	徐康清, 孙培吾, 黄文起, 等. 乌司他丁对体外循环心脏手术后肺功能的影响. 中华胸心血管外科杂志, 2004, 20: 7-9.
14.	舒强, 杨欣玮, 石单, 等. 乌司他丁对小儿体外循环术后肺损伤的保护作用. 中华急诊医学杂志, 2005, 14: 1027-1030.
15.	庄心良, 曾因明, 陈伯銮, 主编. 现代麻醉学. 北京: 人民卫生出版社, 2003 , 1986-1989.
16.	Kondili E, Xirouchaki N, Vaporidi K, et al. Short-term cardiorespiratory effects of proportional assist and pressure-support ventilation in patients with acute lung injury/ acute respiratory distress syndrome. Anesthesiology, 2006, 105: 703 -708.
17.	刘长文, 胡炜, 陆骏, 等. 乌司他丁对心肺转流术心脏手术患者肺损伤的保护作用. 中国危重病急救医学, 2008, 20 : 244.
18.	Chan EY, Bridge PD, Dundas I, et al. Repeatability of airway resistance measurements made using the interrupter technique.Thorax, 2003, 58 : 334-347.

1. Ng CS,Wan S, Yim AP, et al. Pulmonary dysfunction after cardiac surgery. Chest, 2002 , 121: 1269-1277.
2. 杨凯, 沈锦松, 章强松. 乌司他丁治疗创伤后急性肺损伤40 例临床观察. 中国急救医学, 2006, 26: 229-230 .
3. Day JR, Taylor KM. The systemic inflammatory response syndrome and cardiopulmonary bypass. Int J Surg, 2005 , 3: 129-140 .
4. Sievers HH, Freund-Kaas C, Eleftheriadis S, et al. Lung protection during total cardiopulmonary bypass by isolated lung perfusion:preliminary results of a novel perfusion strategy. Ann Thorar Surg,2002, 74: 1167-1172 .
5. Atabai K, Matthay MA. The pulmonary physician in critical care. 5 :Acute lung injury and the acute respiratory distress syndrome:definitions and epidemiology. Thorax, 2002, 57 : 452-458.
6. Brown KA, Brain SD, Pearson JD, et al. Neutrophils in development of multiple organ failure in sepsis. Lancet, 2006 , 368: 157-169 .
7. Nakanishi K, Takeda S, Sakamoto A, et al. Effects of ulinastatin treatement on the cadliopulmonary byass- induced hemodynamic instability and pulmonary dysfunction. Cirt Care Med, 2006, 34 :1351-1357.
8. Masaaki U, Satoshi T, Kousuke C, et al. Urinary Trypsin inhibitor reduces inflammatory response in kidney induced by lipopolysaccharide. J Biosci Bioeng, 2007, 104: 315 -320.
9. 刘虹, 安友仲, 李芳芳, 等. 乌司他丁对脂多糖诱导大鼠急性肺损伤作用的研究. 中国呼吸与危重监护杂志, 2008, 7: 290-293.
10. 姜兴权, 王育珊, 王爽骥, 等. 急性肺损伤肺保护性通气乌司他丁干预的临床研究. 中国急救医学, 2006 , 26: 161-163.
11. 陈聪, 李伦明, 曹明娟, 等. 乌司他丁在体外循环中对肺保护作用的临床研究. 中国心血管病研究杂志, 2007, 5 : 109-112.
12. 李汝勇, 张继红, 李玉芝. 乌司他丁对急性肺损伤机械通气患者肺保护的临床研究. 中国危重病急救医学, 2008, 20: 373-374.
13. 徐康清, 孙培吾, 黄文起, 等. 乌司他丁对体外循环心脏手术后肺功能的影响. 中华胸心血管外科杂志, 2004, 20: 7-9.
14. 舒强, 杨欣玮, 石单, 等. 乌司他丁对小儿体外循环术后肺损伤的保护作用. 中华急诊医学杂志, 2005, 14: 1027-1030.
15. 庄心良, 曾因明, 陈伯銮, 主编. 现代麻醉学. 北京: 人民卫生出版社, 2003 , 1986-1989.
16. Kondili E, Xirouchaki N, Vaporidi K, et al. Short-term cardiorespiratory effects of proportional assist and pressure-support ventilation in patients with acute lung injury/ acute respiratory distress syndrome. Anesthesiology, 2006, 105: 703 -708.
17. 刘长文, 胡炜, 陆骏, 等. 乌司他丁对心肺转流术心脏手术患者肺损伤的保护作用. 中国危重病急救医学, 2008, 20 : 244.
18. Chan EY, Bridge PD, Dundas I, et al. Repeatability of airway resistance measurements made using the interrupter technique.Thorax, 2003, 58 : 334-347.

Chinese Journal of Respiratory and Critical Care Medicine

Ulinastatin Alleviates Lung Injury during Cardopulmonary Bypass in Patients Underwent Valve Replacement Surgery

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