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

 Na-Young Kim ; Jae-Kwang Shim ; Young-Lan Kwak ; Jong-Wook Song ; Jee-Suk Sim ; Seo-Ouk Bang 
 Korean Journal of Anesthesiology (대한마취과학회지), Vol.64(2) : 105~111, 2013 
Journal Title
 Korean Journal of Anesthesiology  (대한마취과학회지) 
Issue Date
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.
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1. 연구논문 > 1. College of Medicine > Dept. of Anesthesiology and Pain Medicine
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