Effects of ulinastatin on coagulation in high-risk patients undergoing off-pump coronary artery bypass graft surgery

Autor: Na-Young Kim, Jae-Kwang Shim, Seo-Ouk Bang, Jee-Suk Sim, Jong-Wook Song, Young-Lan Kwak
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Zdroj: Korean Journal of Anesthesiology, Vol 64, Iss 2, Pp 105-111 (2013)
Druh dokumentu: article
ISSN: 2005-6419
2005-7563
DOI: 10.4097/kjae.2013.64.2.105
Popis: BackgroundBoth systemic inflammatory reaction and regional myocardial ischemia/reperfusion injury may elicit hypercoagulability after off-pump coronary artery bypass grafting (OPCAB). We investigated the influence of ulinastatin, which suppresses the activity of polymorphonuclear leukocyte elastase and production of pro-inflammatory cytokines, on coagulation in patients with elevated high-sensitivity C-reactive protein (hsCRP) undergoing OPCAB.MethodsFifty patients whose preoperative hsCRP > 3.0 mg/L were randomly allocated into the ulinastatin (600,000 U) or control group. Serum concentrations of thrombin-antithrombin complex (TAT) and prothrombin fragment 1+2 (F1+2) were measured preoperatively, immediately after surgery, and at 24 h after surgery, respectively. Secondary endpoints included platelet factor (PF)-4, amount of blood loss, and transfusion requirement.ResultsAll baseline values of TAT, F1+2, and PF-4 were higher than the normal range in both groups. F1+2 was elevated in both groups at immediate, and at 24 h after surgery as compared to baseline value, without any significant intergroup differences. Remaining coagulation parameters, transfusion requirement and blood loss during operation and postoperative 24 h were not different between the two groups.ConclusionsIntraoperative administration of ulinastatin did not convey beneficial influence in terms of coagulation and blood loss in high-risk patients with elevated hsCRP undergoing multivessel OPCAB, who already exhibited hypercoagulability before surgery.
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