ObjectiveTo observe the level of extravascular lung water index (ELWI) in serious septic patients with ARDS,and the effects of ulinastatin (UTI) on ELWI. MethodsA perspective control study was performed on 48 severe septic patients with ARDS from the emergency department and ICU in Shanghai Changzhen Hospital from January 2010 to December 2012. Pulse indicator continuous cardiac output (PICCO) technique was utilized for measuring ELWI. Meanwhile the oxygenation index (PaO2/FiO2) was detected. The patients were randomized as an UTI group (n=30) and a control group (n=18). Both groups received routine comprehensive treatments,and the UTI group additionally received 30 000 units/kg UTI intravenous drip 4 times a day for continuous 3 days. The PaO2/FiO2,ELWI,Murray lung injury score,APACHEⅡ score,SOFA score and 28-day mortality were determined. ResultsThe APACHE Ⅱ score,Murray and SOFA score had no statistical difference between the UTI group and the control group before treatment (P>0.05),and decreased significantly after 4 and 7 days of treatment in both groups compared with those before treatment (P<0.05). There were varying degrees of PaO2/FiO2 decrease and ELWI increase before treatment in both groups with no significant difference between two groups (P>0.05). After treatment,the PaO2/FiO2 increased and ELWI decreased in both groups,and the UTI group had better PaO2/FiO2 and ELWI than the control group (P<0.05). The difference in 28-day mortality between the UTI group and the control group was statistically significant (10.0% vs. 33.3%,P<0.05). ConclusionsSevere septic patients with ARDS are all complicated with ELWI increase. Routine therapy combined with UTI can decrease ELWI,improve clinical symptoms,and decrease 28-day mortality.