Protective effect of ulinastatin on acute lung injury induced by orthotopic liver transplantation / 中华器官移植杂志

ABSTRACT

Objective To evaluate the effects of ulinastatin on acute lung injury during ortho- topic liver transplantation(OLT).Methods Twenty ASAⅢ-Ⅳpatients with end-stage liver disea- ses.undergoing OLT were randomly divided into two groups.Ulinastatin group received intravenous infusion of ulinastatin(3?10~4 IU in 100 normal saline)after skin incision and every 4 h thereafter(n =10).Control group received same amount of normal saline instead of ulinastatin(n=10).Blood sam- pies were taken before skin incision,120 min after skin incision,30 min after liver was removed,5 min and 60 min after reperfusion of the graft and at the end of operation for determination of plasma IL-6, IL-8,TNF-?,MDA concentrations and SOD activity.Respiratory index(RI)[P_(A-a)DO_2/PaO_2]was cal- culated before skin incision,30 min after liver was removed,5 min and 60 min after reperfusion of the graft and at the end of operation.After anesthesia was induced,cardiac output,mixed venous oxygen saturation and central venous temperature were continuously monitored during operation.ECG,CVP, SpO_2,P_(ET)CO_2,radial artery and MPAP were also continuously monitored during operation.P_(ET)CO_2 was maintained at 35-40 mm Hg during operation.Blood temperature was maintained above 35.5℃during operation.Results In group C plasma IL-6 and IL-8 concentrations were significantly increased from 120 min after skin incision to the end of operation as compared with the baseline values(P0.05).RI was significantly lower at 60 min after reperfusion of the graft and at the end of operation in group U than in group C(P