Effect of ulinastatin on renal function during perioperative period in infants undergoing open heart surgery under CPB

Objective To investigate the effect of ulinastatin on the renal function during perioperative period in infants undergoing open heart surgery under CPB.Methods Forty ASA Ⅱ infants (25 male, 15 female)aged 3-5 months weighing 5.3-6.8 kg undergoing open heart surgery under CPB were randomly divided into 2 groups (n = 20 each): control group (group C) and ulinastatin group (group U). Ulinastatin 20 000 U/kg in normal saline 20 ml was infused iv in 3 parts (1/3 was infused via CVP line when the catheter was successfully placed in the internal jugular vein; 1/3 at the beginning of CPB and 1/3 at aortic unclamping). Blood and urine samples were collected at 30 min before incision ( T1 ), 5 min before aortic clamping (T2 ), 5 min after aortic unclamping (T3 ), at the end of operation (T4) and 24 and 48 h after operation (T5, T6 ) for determination of serum urea nitrogen (BUN) and creatinine (Cr) and urinary N-acetyl-β-D-glucosaminidase (NAG) and β2-microglubin (β2-MG) levels. Results There was no significant difference in serum BUN and Cr concentrations between the two groups. The urinary β2-MG concentration and NAG activity were significantly increased at T2-6 as compared with baseline values at T1 in both groups. The urinary β2-MG concentration and NAG activity were significantly lower in group U than in group C at T3-5 . Conclusion Ulinastatin can protect the renal function during perioperative period in infants undergoing open heart surgery under CPB. Key words: Trypsin inhibitors; Kidney function tests; Cardiopulmonary bypass; Infant