Effect of ulinastatin on perioperative glycocalyx and lung function in patients undergoing mitral valve replacement surgery.
10.11817/j.issn.1672-7347.2018.06.011
- Author:
Qiang LÜ
1
;
Deliang WANG
1
;
Dongli XIE
1
Author Information
1. Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China.
- Publication Type:Journal Article
- MeSH:
Cardiopulmonary Bypass;
Glycocalyx;
drug effects;
Glycoproteins;
pharmacology;
Heart Valve Prosthesis Implantation;
Humans;
Lung;
drug effects;
Mitral Valve;
surgery;
Oxygen;
blood;
Syndecan-1;
blood;
Time Factors;
Tumor Necrosis Factor-alpha;
blood
- From:
Journal of Central South University(Medical Sciences)
2018;43(6):646-650
- CountryChina
- Language:Chinese
-
Abstract:
To explore the effect of ulinastatin on perioperative glycocalyx and lung function in patients undergoing mitral valve replacement surgery.
Methods: Fourty patients, undergoing mitral valve replacement, were randomly allocated into a control group and an ulinastatin group, which were administrated 50 mL normal saline or 2×104 U/kg ulinastatin at the beginning of cardiopulmonary bypass (CPB), respectively. The radical artery blood was collected at 4 time points: After induction of anesthesia (T0), at 10 min after the start of CPB (T1), 1 h after the end of CPB (T2), and 8 h after operation. The concentration of syndecan-1 and TNF-α in blood was measured. Moreover, the blood gas analysis was preformed and the oxygen index (OI) and difference in alveolar arterial oxygen partial pressure (PA-aO2) were calculated at T0, T2, and T3.
Results: There were no significant difference between the 2 groups in OI, PA-aO2, and the concentration of syndecan-1 and TNF-α at T0 (P>0.05). The concentration of syndecan-1 and TNF-α was significantly increased at T1 and T2 in the 2 groups, and reached peak at T2. Compared with the control group, the concentration of syndecan-1 and TNF-α was decreased in the ulinastatin group at T1, T2, and T3 (P<0.05). Compared with T0, OI was lower and PA-aO2 was higher at T2 and T3 in both groups, but the 2 indexes were improved in the ulinastatin group compared with those in the control group (P<0.05).
Conclusion: Ulinastatin can improve the post-operative pulmonary ventilation function in patients with mitral valve replacement. The mechanism may be associated with the inhibition of TNF-α release and the reduction of glycocalyx shedding induced by ulinastatin.
