Abstract OBJECTIVE: To study the effects of ulinastatin on coagulation in children who underwent open-heart surgery with cardiopulmonary bypass (CPB). METHODS: Fifty children who underwent open-heart surgery for ventricular septal defect were randomly divided into two groups: ulinastatin treatment and control. Before CPB, ulinastatin (1.0×104 U/kg) was added to CPB priming fluid only in the ulinastatin treatment group. Activated partial thromboplasin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen and international normalized ratio (INR) were measured both before and at 1 hr, 6 hrs and 24 hrs after CPB. RESULTS: The PT in the ulinastatin group was more prolonged than in the control group at 1 hr after CPB (18.7±0.7 s vs 15.5±0.5 s) and 6 hrs after CPB (17.5±0.6 s vs 15.0±0.6 s). The APTT in the ulinatatin group was also significantly more prolonged than in the control group at 6 hrs after CPB (38.7±3.1 s vs 35.3±3.1 s) and 24 hrs after CPB (34.2±3.0 s vs 31.1±2.6 s). CONCLUSIONS: Ulinastatin may prolong PT and APTT after CPB, and thus affects coagulation in children.
HUANG Peng,LIU Ping-Bo,LUO Jin-Wen et al. Effects of ulinastatin on coagulation in children after cardiopulmonary bypass[J]. 中国当代儿科杂志, 2012, 14(4): 279-281.
HUANG Peng,LIU Ping-Bo,LUO Jin-Wen et al. Effects of ulinastatin on coagulation in children after cardiopulmonary bypass[J]. CJCP, 2012, 14(4): 279-281.
[3]Nishiyama T, Yokoyama T, Yamashita K. Effects of a protease inhibitor, ulinastatin, on coagulation and fibrinolysis in abdominal surgery[J]. J Anesth, 2006, 20 (3): 179-182.
[4]Kawamura T, Inada K, Akasaka N, Wakusawa R. Ulinastatin reduces elevation of cytokines and soluble adhesion molecules during cardiac surgery[J]. Can J Anaesth, 1996, 43 (5 Pt 1): 456-460.
[5]Pugia MJ, Valdes R Jr, Jortani SA. Bikunin (urinary trypsin inhibitor): structure, biological relevance, and measurement[J]. Adv Clin Chem, 2007, 44: 223-245.
[6]Kobayashi H, Suzuki M, Hirashima Y, Terao T. The protease inhibitor bikunin, a novel anti-metastatic agent[J]. Biol Chem, 2003, 384 (5): 749-754.
[7]Nii A, Morishita H, Yamakawa T, Matsusue T, Hirose J, Miura T, et al. Design of variants of the second domain of urinary trypsin inhibitor (R-020) with increased factor Xa inhibitory activity[J]. J Biochem, 1994, 115(6): 1107-1112.
[8]Ten Cate H, Bauer KA, Levi M, Edgington TS, Sublett RD, Barzegar S, et al. The activation of factor X and prothrombin by recombinant factor VIIa in vivo is mediated by tissue factor[J]. J Clin Invest, 1993, 92(3): 1207-1212.