Effects of ulinastatin on coagulation in high-risk patients undergoing off-pump coronary artery bypass graft surgery / 대한마취과학회지
Korean Journal of Anesthesiology
; : 105-111, 2013.
Article
in En
| WPRIM
| ID: wpr-59815
Responsible library:
WPRO
ABSTRACT
BACKGROUND: Both 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. METHODS: Fifty 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. RESULTS: All 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. CONCLUSIONS: Intraoperative 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.
Key words
Full text:
1
Index:
WPRIM
Main subject:
Peptide Hydrolases
/
Reference Values
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Blood Platelets
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C-Reactive Protein
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Prothrombin
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Glycoproteins
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Antithrombin III
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Cytokines
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Leukocyte Elastase
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Thrombophilia
Type of study:
Etiology_studies
Limits:
Humans
Language:
En
Journal:
Korean Journal of Anesthesiology
Year:
2013
Type:
Article