The Effects of Urinary Trypsin Inhibitor on the Outcomes of Severe Sepsis and Septic Shock Patients.
- Author:
Sung Woo MOON
1
;
Sung Woo LEE
;
Yun Sik HONG
;
Dae Won PARK
;
Ik Jin JANG
;
Young Hoon YOON
;
Sung Ik LIM
Author Information
1. Department of Emergency Medicine, College of Medicine, Korea University, Seoul, Korea, Division of Infection, Korea. kuedlee@korea.ac.kr
- Publication Type:Original Article
- Keywords:
Septic shock;
Severe sepsis;
Urinary trypsin inhibitor
- MeSH:
Arterial Pressure;
Case-Control Studies;
Emergencies;
Glycoproteins;
Hospital Mortality;
Humans;
Prospective Studies;
Sepsis;
Shock, Septic;
Trypsin
- From:Journal of the Korean Society of Emergency Medicine
2009;20(1):80-85
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We purposed to determine the effects of urinary typsin inhibitor (ulinastatin) on the outcomes of severe sepsis and septic shock patients. METHODS: This is a prospective case control study of severe sepsis and septic shock patients who visited emergency department of university hospital from January 2005 to June 2008. For study group, 100,000 U of ulinastatin was initially infused and then additional infusions of ulinastatin were determined by the mean arterial pressure. We compared the predicted mortality and the actual in-hospital mortality between the ulinastatin group and the control group. We also compared the improvement of the SOFA score according to time between the groups. RESULTS: There were 43 patients in the ulinastatin group and 126 patients in the control group. The predicted mortality and the actual mortality of the ulinastatin group were 31.2% and 18.6%, respectively. The predicted and actual mortalities of the control group were 33.1% and 27.0%, respectively. The improvement of the SOFA score for the ulinastatin group was 6.8+/-3.9 and 5.0+/-4.5 at 0 and 24 hours (p<0.001), 6.5+/-3.7 and 3.9+/-4.3 at 0 and 48 hours (p<0.001) and, 6.3+/-3.6 and 3.0+/-4.1 at 0 and 72 hours (p<0.001). For the control group, the change of the SOFA score was 4.9+/-2.9 and 5.8+/-4.1 at 0 and 24 hours (p=0.003), 5.0+/-2.8 and 5.1+/-4.2 at 0 and 48 hours (p=0.760) and, 4.8+/-2.7 and 4.34.1 at 0 and 72 hours (p=0.105). CONCLUSION: The ulinastatin group showed significantly lower mortality than the predicted mortality and the ulinastatin group's SOFA score was improved in the early hospital days.
