Role of Ulinastatin, a trypsin inhibitor, in severe acute pancreatitis in critical care setting: A retrospective analysis

PURPOSE: To evaluate the clinical utility of Ulinastatin, a multifunctional serine protease inhibitor, in the management of severe acute pancreatitis. MATERIALS AND METHODS: We conducted a retrospective analysis of the archived data of adult patients diagnosed with acute pancreatitis and admitted to surgical intensive care unit with one or more end organ dysfunction. The patients were divided into two groups depending on whether they did or did not receive ulinastatin. Outcome variables namely in-hospital mortality, development of new-onset organ dysfunction, resolution of existing organ dysfunction by Day 5 and length of hospital stay were compared. RESULTS: Forty-eight patients, 25 who received Ulinastatin (Ulinastatin group) and 23 who did not (Control group) were analyzed. The in-hospital mortality was significantly lower in the Ulinastatin group (16% vs 69.6%; p = 0.0003). Significantly smaller proportion of patients (24% vs 73.9%; p = 0.0005) developed new-onset organ dysfunction in the ulinastatin group by day 5. Resolution of existing organ dysfunctions by day 5 was more frequent in the ulinastatin group. Duration of hospital stay was similar in the two groups. CONCLUSION: Ulinastatin treatment was associated with improved outcomes in patients with severe acute pancreatitis.