Effects of different doses of ulinastatin on early inflammatory responses and prognosis in patients with extremely severe burns: A retrospective observational cohort study.

Abstract

ObjectiveThis study aimed to investigate the impact of routine- and high-dose ulinastatin on the occurrence of burn sepsis, early-phase inflammatory responses and organ function indices in patients with extremely severe burns.MethodsA retrospective observational study was conducted involving 106 patients with extremely severe burns. These patients were categorized into three groups: routine treatment, routine-dose ulinastatin treatment, and high-dose ulinastatin treatment. All patients received standard care, including fluid resuscitation, anti-infection therapy, and surgical debridement. Patients in the two ulinastatin groups received intravenous ulinastatin at doses of 100 kU and 300 kU three times daily for seven days. Inflammatory and organ function markers were measured at admission and on post-burn days 3 and 7. The primary clinical outcome within 30 days after burn injury was burn sepsis. Multivariable binary logistic regression was performed to identify predictors associated with burn sepsis.ResultsOn post-burn day 7, the high-dose ulinastatin treatment group exhibited lower white blood cell (WBC) and neutrophil counts, and blood urea nitrogen (BUN) than the routine treatment group (all P < 0.05). In addition, the routine-dose treatment group showed a reduced neutrophil count compared to the routine treatment group (P < 0.05). The 30-day incidence of burn sepsis was significantly lower in the high-dose ulinastatin treatment group (P < 0.05). Multivariable binary logistic regression analysis identified that high-dose ulinastatin therapy was independently associated with a lower risk of burn sepsis, whereas inhalation injury and time to first surgical debridement were independently associated with a higher risk of burn sepsis.ConclusionThis study shows that high-dose ulinastatin is associated with a blunted inflammatory response, lower BUN levels, and lower odds of burn sepsis in patients with extremely severe burns.