Effects of ulinastatin on coagulation in high-risk patients undergoing off-pump coronary artery bypass graft surgery

Na Young Kim, Jae Kwang Shim, Seo Ouk Bang, Jee Suk Sim, Jong Wook Song, Young Lan Kwak

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Both systemic inflammatory reaction and regional myocardial ischemia/reperfusion injury may elicit hypercoagulability after off-pump coronary artery bypass grafting (OPCAB). We investigated the influence of ulinastatin, which suppresses the activity of polymorphonuclear leukocyte elastase and production of pro-inflammatory cytokines, on coagulation in patients with elevated high-sensitivity C-reactive protein (hsCRP) undergoing OPCAB. Methods: Fifty patients whose preoperative hsCRP > 3.0 mg/L were randomly allocated into the ulinastatin (600,000 U) or control group. Serum concentrations of thrombin-antithrombin complex (TAT) and prothrombin fragment 1+2 (F1+2) were measured preoperatively, immediately after surgery, and at 24 h after surgery, respectively. Secondary endpoints included platelet factor (PF)-4, amount of blood loss, and transfusion requirement. Results: All baseline values of TAT, F1+2, and PF-4 were higher than the normal range in both groups. F1+2 was elevated in both groups at immediate, and at 24 h after surgery as compared to baseline value, without any significant intergroup differences. Remaining coagulation parameters, transfusion requirement and blood loss during operation and postoperative 24 h were not different between the two groups. Conclusions: Intraoperative administration of ulinastatin did not convey beneficial influence in terms of coagulation and blood loss in high-risk patients with elevated hsCRP undergoing multivessel OPCAB, who already exhibited hypercoagulability before surgery.

Original languageEnglish
Pages (from-to)105-111
Number of pages7
JournalKorean Journal of Anesthesiology
Volume64
Issue number2
DOIs
Publication statusPublished - 2013 Feb 1

Fingerprint

Off-Pump Coronary Artery Bypass
Coronary Artery Bypass
C-Reactive Protein
Platelet Factor 4
Transplants
Thrombophilia
Blood Transfusion
Myocardial Reperfusion Injury
Leukocyte Elastase
Blood Coagulation
Reperfusion Injury
Myocardial Ischemia
Reference Values
Cytokines
Control Groups
urinastatin
Serum
antithrombin III-protease complex

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Kim, Na Young ; Shim, Jae Kwang ; Bang, Seo Ouk ; Sim, Jee Suk ; Song, Jong Wook ; Kwak, Young Lan. / Effects of ulinastatin on coagulation in high-risk patients undergoing off-pump coronary artery bypass graft surgery. In: Korean Journal of Anesthesiology. 2013 ; Vol. 64, No. 2. pp. 105-111.
@article{44c111fa36c04b1c8602ad81e289d130,
title = "Effects of ulinastatin on coagulation in high-risk patients undergoing off-pump coronary artery bypass graft surgery",
abstract = "Background: Both systemic inflammatory reaction and regional myocardial ischemia/reperfusion injury may elicit hypercoagulability after off-pump coronary artery bypass grafting (OPCAB). We investigated the influence of ulinastatin, which suppresses the activity of polymorphonuclear leukocyte elastase and production of pro-inflammatory cytokines, on coagulation in patients with elevated high-sensitivity C-reactive protein (hsCRP) undergoing OPCAB. Methods: Fifty patients whose preoperative hsCRP > 3.0 mg/L were randomly allocated into the ulinastatin (600,000 U) or control group. Serum concentrations of thrombin-antithrombin complex (TAT) and prothrombin fragment 1+2 (F1+2) were measured preoperatively, immediately after surgery, and at 24 h after surgery, respectively. Secondary endpoints included platelet factor (PF)-4, amount of blood loss, and transfusion requirement. Results: All baseline values of TAT, F1+2, and PF-4 were higher than the normal range in both groups. F1+2 was elevated in both groups at immediate, and at 24 h after surgery as compared to baseline value, without any significant intergroup differences. Remaining coagulation parameters, transfusion requirement and blood loss during operation and postoperative 24 h were not different between the two groups. Conclusions: Intraoperative administration of ulinastatin did not convey beneficial influence in terms of coagulation and blood loss in high-risk patients with elevated hsCRP undergoing multivessel OPCAB, who already exhibited hypercoagulability before surgery.",
author = "Kim, {Na Young} and Shim, {Jae Kwang} and Bang, {Seo Ouk} and Sim, {Jee Suk} and Song, {Jong Wook} and Kwak, {Young Lan}",
year = "2013",
month = "2",
day = "1",
doi = "10.4097/kjae.2013.64.2.105",
language = "English",
volume = "64",
pages = "105--111",
journal = "Korean Journal of Anesthesiology",
issn = "2005-6419",
publisher = "Korean Society of Anesthesiologists",
number = "2",

}

Effects of ulinastatin on coagulation in high-risk patients undergoing off-pump coronary artery bypass graft surgery. / Kim, Na Young; Shim, Jae Kwang; Bang, Seo Ouk; Sim, Jee Suk; Song, Jong Wook; Kwak, Young Lan.

In: Korean Journal of Anesthesiology, Vol. 64, No. 2, 01.02.2013, p. 105-111.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of ulinastatin on coagulation in high-risk patients undergoing off-pump coronary artery bypass graft surgery

AU - Kim, Na Young

AU - Shim, Jae Kwang

AU - Bang, Seo Ouk

AU - Sim, Jee Suk

AU - Song, Jong Wook

AU - Kwak, Young Lan

PY - 2013/2/1

Y1 - 2013/2/1

N2 - Background: Both systemic inflammatory reaction and regional myocardial ischemia/reperfusion injury may elicit hypercoagulability after off-pump coronary artery bypass grafting (OPCAB). We investigated the influence of ulinastatin, which suppresses the activity of polymorphonuclear leukocyte elastase and production of pro-inflammatory cytokines, on coagulation in patients with elevated high-sensitivity C-reactive protein (hsCRP) undergoing OPCAB. Methods: Fifty patients whose preoperative hsCRP > 3.0 mg/L were randomly allocated into the ulinastatin (600,000 U) or control group. Serum concentrations of thrombin-antithrombin complex (TAT) and prothrombin fragment 1+2 (F1+2) were measured preoperatively, immediately after surgery, and at 24 h after surgery, respectively. Secondary endpoints included platelet factor (PF)-4, amount of blood loss, and transfusion requirement. Results: All baseline values of TAT, F1+2, and PF-4 were higher than the normal range in both groups. F1+2 was elevated in both groups at immediate, and at 24 h after surgery as compared to baseline value, without any significant intergroup differences. Remaining coagulation parameters, transfusion requirement and blood loss during operation and postoperative 24 h were not different between the two groups. Conclusions: Intraoperative administration of ulinastatin did not convey beneficial influence in terms of coagulation and blood loss in high-risk patients with elevated hsCRP undergoing multivessel OPCAB, who already exhibited hypercoagulability before surgery.

AB - Background: Both systemic inflammatory reaction and regional myocardial ischemia/reperfusion injury may elicit hypercoagulability after off-pump coronary artery bypass grafting (OPCAB). We investigated the influence of ulinastatin, which suppresses the activity of polymorphonuclear leukocyte elastase and production of pro-inflammatory cytokines, on coagulation in patients with elevated high-sensitivity C-reactive protein (hsCRP) undergoing OPCAB. Methods: Fifty patients whose preoperative hsCRP > 3.0 mg/L were randomly allocated into the ulinastatin (600,000 U) or control group. Serum concentrations of thrombin-antithrombin complex (TAT) and prothrombin fragment 1+2 (F1+2) were measured preoperatively, immediately after surgery, and at 24 h after surgery, respectively. Secondary endpoints included platelet factor (PF)-4, amount of blood loss, and transfusion requirement. Results: All baseline values of TAT, F1+2, and PF-4 were higher than the normal range in both groups. F1+2 was elevated in both groups at immediate, and at 24 h after surgery as compared to baseline value, without any significant intergroup differences. Remaining coagulation parameters, transfusion requirement and blood loss during operation and postoperative 24 h were not different between the two groups. Conclusions: Intraoperative administration of ulinastatin did not convey beneficial influence in terms of coagulation and blood loss in high-risk patients with elevated hsCRP undergoing multivessel OPCAB, who already exhibited hypercoagulability before surgery.

UR - http://www.scopus.com/inward/record.url?scp=84874610723&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84874610723&partnerID=8YFLogxK

U2 - 10.4097/kjae.2013.64.2.105

DO - 10.4097/kjae.2013.64.2.105

M3 - Article

C2 - 23459312

AN - SCOPUS:84874610723

VL - 64

SP - 105

EP - 111

JO - Korean Journal of Anesthesiology

JF - Korean Journal of Anesthesiology

SN - 2005-6419

IS - 2

ER -