Effect of ulinastatin on post-operative blood loss and allogeneic transfusion in patients receiving cardiac surgery with cardiopulmonary bypass: a prospective randomized controlled study with 10-year follow-up

Autor: Peng Zhang, Hong Lv, Xia Qi, Wenjing Xiao, Qinghua Xue, Lei Zhang, Lihuan Li, Jia Shi
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal of Cardiothoracic Surgery, Vol 15, Iss 1, Pp 1-11 (2020)
Druh dokumentu: article
ISSN: 1749-8090
DOI: 10.1186/s13019-020-01144-9
Popis: Abstract Background Major bleeding and allogeneic transfusion leads to negative outcomes in patients receiving cardiac surgery with cardiopulmonary bypass (CPB). Ulinastatin, a urine trypsin inhibitor, relieves systemic inflammation and improves coagulation profiles with however sparse evidence of its effects on blood loss and allogeneic transfusion in this specific population. Methods In this prospective randomized controlled trial, 426 consecutive patients receiving open heart surgery with CPB were randomly assigned into three groups to receive ulinastatin (group U, n = 142), tranexamic acid (group T, n = 143) or normal saline (group C, n = 141). The primary outcome was the total volume of post-operative bleeding and the secondary outcome included the volume and exposure of allogeneic transfusion, the incidence of stroke, post-operative myocardial infarction, renal failure, respiratory failure and all-cause mortality. A ten-year follow-up was carried on to evaluate long-term safety. Results Compared with placebo, ulinastatin significantly reduced the volume of post-operative blood loss within 24 h (688.39 ± 393.55 ml vs 854.33 ± 434.03 ml MD − 165.95 ml, 95%CI − 262.88 ml to − 69.01 ml, p
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