Effects of ulinastatin on pulmonary artery pressure during abdominal aortic aneurysmectomy

Journal of Clinical Anesthesia
Saori KurosawaAkiyoshi Namiki

Abstract

Abdominal aortic aneurysmectomy (AAAectomy) results in a general ischemia-reperfusion syndrome accompanied by an acute rise in pulmonary artery pressure (PAP). We examined whether ulinastatin, a urinary trypsin inhibitor, prevents ischemia-reperfusion injury and increase in PAP after aortic unclamping (XU) during AAAectomy. Prospective study. Public, university-affiliated hospital. Sixteen patients (11 males and 5 females) scheduled for AAAectomy. The patients received 300000 IU of ulinastatin intravenously before XU (n = 8) or no additional treatment (n = 8) (control). Heart rate, central venous pressure, PAP, pulmonary arterial wedge pressure, arterial pressure, mixed venous oxygen saturation (Sv(O2)), and cardiac output were monitored. Arterial and mixed venous blood samples were analyzed for pH, Pa(CO2), Pa(O2), hemoglobin, and oxygen saturation, and the physiological shunt function (Qs/Qt) were calculated. Plasma concentrations of malondialdehyde, myeloperoxidase, granulocyte elastase, alpha1-antitrypsine, and thromboxane B2 and the stable hydrolysis products of thromboxane A2 were measured. Measurements were conducted before aortic crossclamping (XC) (baseline) and at 10, 30, and 60 minutes after XU. A significant increas...Continue Reading

Citations

Apr 7, 2010·Expert Opinion on Investigational Drugs·Ken-ichiro Inoue, Hirohisa Takano
Feb 11, 2009·Burns : Journal of the International Society for Burn Injuries·Chengjin GaoJiajun Tang
Jul 20, 2010·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·B KücükakinI Gögenur

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