Yi Lyu, Mengyuan Cao, Cuina Wei, Hao Fang, Xianfu Lu
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Complete blood count and coagulation function test were conducted 1 day before surgery and on the first postoperative day. Bleeding and other safety events were recorded during hospitalization.</p><p><strong>Results: </strong>Less postoperative major bleeding occurred in the ulinastatin group (0.4 vs. 6.7%, p = 0.03). Moreover, 1 day after CPB, platelet count in the ulinastatin group increased significantly compared to that in the control group (157.7 ± 71.0 vs. 132.1 ± 59.6, p = 0.03). Interestingly and contrary to what was expected, activated partial thromboplastin time (APTT) and prothrombin time (PT) did not differ significantly between the two groups. Ulinastatin application did not cause significant increase in total costs (p = 0.89).</p><p><strong>Conclusion: </strong>In heart valve replacement surgery with CPB, high-dose ulinastatin could reduce postoperative bleeding and promote platelet recovery with no significant additional medical cost.</p>","PeriodicalId":13963,"journal":{"name":"International journal of clinical pharmacology and therapeutics","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"High-dose ulinastatin reduces postoperative bleeding and provides platelet-protective effects in patients undergoing heart valve replacement surgery.\",\"authors\":\"Yi Lyu, Mengyuan Cao, Cuina Wei, Hao Fang, Xianfu Lu\",\"doi\":\"10.5414/CP204219\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The aim of this prospective study was to investigate the effect of a high dose of ulinastatin on platelets and coagulation in patients undergoing mitral valve and/or aortic valve replacement with cardiopulmonary bypass (CPB).</p><p><strong>Materials and methods: </strong>273 patients were enrolled in this open-label study. 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引用次数: 0
摘要
背景:本前瞻性研究的目的是研究大剂量乌司他丁对二尖瓣和/或主动脉瓣置换术合并体外循环(CPB)患者血小板和凝血功能的影响。材料和方法:273名患者被纳入这项开放标签研究。根据患者意愿,将243例患者分为乌司他丁组,30例患者分为对照组。乌司他丁组在麻醉诱导后给予乌司他丁(300,000 U),在CPB泵起始处加入乌司他丁(400,000 U),在CPB断奶后给予乌司他丁(300,000 U)。术前1天和术后第1天分别进行全血细胞计数和凝血功能检查。住院期间记录出血和其他安全事件。结果:乌司他汀组术后大出血发生率较对照组低(0.4 vs. 6.7%, p = 0.03)。CPB后1 d,乌司他汀组血小板计数明显高于对照组(157.7±71.0比132.1±59.6,p = 0.03)。有趣的是,与预期相反,活化的部分凝血活素时间(APTT)和凝血酶原时间(PT)在两组之间没有显著差异。应用乌司他丁未引起总费用的显著增加(p = 0.89)。结论:在CPB心脏瓣膜置换术中,大剂量乌司他丁可减少术后出血,促进血小板恢复,且无明显的额外医疗费用。
High-dose ulinastatin reduces postoperative bleeding and provides platelet-protective effects in patients undergoing heart valve replacement surgery.
Background: The aim of this prospective study was to investigate the effect of a high dose of ulinastatin on platelets and coagulation in patients undergoing mitral valve and/or aortic valve replacement with cardiopulmonary bypass (CPB).
Materials and methods: 273 patients were enrolled in this open-label study. According to patients' willingness, 243 patients were assigned to the ulinastatin group and 30 to the control group. In the ulinastatin group, ulinastatin (300,000 U) was given after the induction of anesthesia, ulinastatin (400,000 U) was added to the CPB pump prime, and then ulinastatin (300,000 U) was administered after weaning from CPB. Complete blood count and coagulation function test were conducted 1 day before surgery and on the first postoperative day. Bleeding and other safety events were recorded during hospitalization.
Results: Less postoperative major bleeding occurred in the ulinastatin group (0.4 vs. 6.7%, p = 0.03). Moreover, 1 day after CPB, platelet count in the ulinastatin group increased significantly compared to that in the control group (157.7 ± 71.0 vs. 132.1 ± 59.6, p = 0.03). Interestingly and contrary to what was expected, activated partial thromboplastin time (APTT) and prothrombin time (PT) did not differ significantly between the two groups. Ulinastatin application did not cause significant increase in total costs (p = 0.89).
Conclusion: In heart valve replacement surgery with CPB, high-dose ulinastatin could reduce postoperative bleeding and promote platelet recovery with no significant additional medical cost.
期刊介绍:
The International Journal of Clinical Pharmacology and Therapeutics appears monthly and publishes manuscripts containing original material with emphasis on the following topics: Clinical trials, Pharmacoepidemiology - Pharmacovigilance, Pharmacodynamics, Drug disposition and Pharmacokinetics, Quality assurance, Pharmacogenetics, Biotechnological drugs such as cytokines and recombinant antibiotics. Case reports on adverse reactions are also of interest.