Gu-Yan Wang1, Hong-Bo Qiu, Shu-Gui Zhan, Li-Huan Li. 1. Department of Anesthesiology, Cardiovascular Institute and Fuwai Hospital, Peking Union Medical College and China Academy of Medical Sciences, Beijing, China.
Abstract
OBJECTIVE: To investigate the protective effect of ulinastatin against myocardial injury induced by off-pump coronary artery bypass graft surgery (OPCAB). METHODS:Twenty-four patients undergoing OPCAB were randomly divided into 2 equal groups: ulinastatin group in which ulinastatin was infused intravenously, firstly at the concentration of 6000 U/kg dissolved in 50 ml normal saline for 30 min and then at the speed of 1000 U.kg(-1).h(-1) up to the end of operation, and control group that underwent infusion of normal saline of the same volume. Blood samples were collected before skin incision, 0.5 h after the completion of vascular anastomosis, and 2, 6, and 18 h after the operation to detect the plasma level of cardiac troponin 1 (cTn1). RESULTS: The cTn1 levels 2, 6, and 18 h after the operation of both groups were all significantly higher than those before skin incision (all P < 0.01). The cTn1 levels 0.5 h after the completion of vascular anastomosis, and 2, 6, and 18 h after the operation of the ulinastatin group were all significantly lower than those of the control group (all P < 0.01). CONCLUSION:Ulinastatin decreases the cTn1 level that increases peri-operatively, thus reducing the risk of myocardial injury in patients undergoing OPCAB.
RCT Entities:
OBJECTIVE: To investigate the protective effect of ulinastatin against myocardial injury induced by off-pump coronary artery bypass graft surgery (OPCAB). METHODS: Twenty-four patients undergoing OPCAB were randomly divided into 2 equal groups: ulinastatin group in which ulinastatin was infused intravenously, firstly at the concentration of 6000 U/kg dissolved in 50 ml normal saline for 30 min and then at the speed of 1000 U.kg(-1).h(-1) up to the end of operation, and control group that underwent infusion of normal saline of the same volume. Blood samples were collected before skin incision, 0.5 h after the completion of vascular anastomosis, and 2, 6, and 18 h after the operation to detect the plasma level of cardiac troponin 1 (cTn1). RESULTS: The cTn1 levels 2, 6, and 18 h after the operation of both groups were all significantly higher than those before skin incision (all P < 0.01). The cTn1 levels 0.5 h after the completion of vascular anastomosis, and 2, 6, and 18 h after the operation of the ulinastatin group were all significantly lower than those of the control group (all P < 0.01). CONCLUSION: Ulinastatin decreases the cTn1 level that increases peri-operatively, thus reducing the risk of myocardial injury in patients undergoing OPCAB.