Effects of ulinastatin on the lung injury in patients undergoing off-pump coronary artery bypass graft surgery

Objective To investigate the effects of ulinastatin on the lung injury in patients undergoing off-pump coronary artery bypass graft(OPCABG).Methods 30 patients undergoing selective OPCABG were double-blindly and randomly divided into ulinastatin group(group U,n=15)and control group(group C,n= 15).Ulinastatin 6 000 U/kg was infused intravenously over 30min after anesthesia induction,then ulinastatin 1 000 U·kg -1 ·h -1 was continuously infused until the end of the operation in group U.However in group C, equal volume normal saline at the same infusion rate was infused instead of ulinastatin.The indexes including MPAP,PCWP,SVO2 and PVR were detected respectively before operation(T1),at the time of opening vessel bypass(T2),at the end of the operation(T3)and 8h after the operation(T4).The indexes of lung function, including P(A-a)DO2,RI,QS/QT,VD/VT,Raw,PVR and CL were calculated.The venous blood samples were taken at the different time points(T1,T2,T3,T4)and 24h after operation(T5),and the plasma levels of IL-6, IL-10,TNF-αand CD11b/CD18 were detected.Results As compared with baseline values(T1),P(A-a)DO2, RI and Raw at T3～4,PVR at T2～4,IL-6,CD11b/CD1 at T2,3,TNF-αat T2～5 were significantly increased in both groups(P0.05).At the same time,CL at T3 was obviously decreased in both groups(P0.05).As compared with those in group C,P(A-a)DO2,RI and PVR at T3～4,VD/VT and OI at T2～4,IL-6 and IL-10 at T3,TNF-αand CD11b/CD18 at T2～5 were significantly decreased in group U(P0.05).CL at T2 in group U was significantly higher than that in group C(P0.05).Conclusion Ulinastatin can relieve lung injury and protect lung function in patients undergoing OPCABG at perioperative period by inhibiting the expressions of IL-6, IL-10,TNF-αand CD11b/CD18.