High-dose ulinastatin improves postoperative oxygenation in patients undergoing aortic valve surgery with cardiopulmonary bypass: A retrospective study

Abstract

ObjectiveTo determine whether pre-treatment with high-dose ulinastatin provides enhanced postoperative oxygenation in patients who have undergone aortic valve surgery with moderate hypothermic cardiopulmonary bypass (CPB).MethodsPatients who underwent aortic valve surgery with moderate hypothermic CPB were retrospectively evaluated. In total, 94 of 146 patients were included. The patients were classified into one of two groups: patients in whom ulinastatin (10,000 U/kg followed by 5,000 U/kg/h) was administered during CPB (Group U, n = 38) and patients in whom ulinastatin was not administered (Group C, n = 56). The PaO2/FiO2 ratio was calculated at the following time points: before CPB (pre-CPB), 2 h after weaning from CPB (post-CPB), and 6 h after arrival to the intensive care unit (ICU-6). The incidence of a low PaO2/FiO2 ratio was also compared among the time points.ResultsGroup U showed a significantly higher PaO2/FiO2 ratio (F(4, 89.0) = 657.339) and a lower incidence of lung injury (PaO2/FiO2 ratio < 300) than Group C at the post-CPB and ICU-6 time points.ConclusionHigh-dose ulinastatin improved pulmonary oxygenation after CPB and in the early stages of the ICU stay in patients undergoing aortic valve surgery with CPB.

Postoperative Changes in Pulmonary Function after Valve Surgery: Oxygenation Index Early after Cardiopulmonary Is a Predictor of Postoperative Course

“…Pulmonary function parameters were calculated as follows: PFR = PaO 2 /FiO 2 , alveolar–arterial oxygen gradient (AaDO 2 ) = (760 − 47) × FiO 2 − PaCO 2 /0.8 − PaO 2 , and respiratory index (RI) = AaDO 2 /PaO 2 [ 14 ]. PCLI was defined as PFR < 300 measured 2 h after CPB cessation [ 2 , 6 , 7 ]. Extubation within 6 h after surgery was defined as early extubation, whereas DMV > 24 h was considered as prolonged.…”

“…PaO 2 /FiO 2 (PFR) is the ratio of arterial oxygen tension (PaO 2 ) to the fraction of inspired oxygen (FiO 2 ). PFR is frequently used as an indicator of pulmonary function; post-CPB lung injury (PCLI) is usually defined as a PFR of less than 300 [ 6 , 7 ]. Patients with PCLI have unfavorable postoperative outcomes in cardiac surgery [ 2 , 8 ].…”

Effects of penehyclidine hydrochloride combined with dexmedetomidine on pulmonary function in patients undergoing heart valve surgery: A Double-Blind, Randomized Trial

“…A decrease in OI value indicates a decline in pulmonary ventilation and exchange oxygenation, while a decrease in RI indicates strong pulmonary gas diffusion and exchange capacity and good ventilation volume. In the perioperative period of cardiac surgery with CPB, OI < 300 is usually de ned as pulmonary injury [25] . When CPB-related pulmonary injury or ischemia/reperfusion injury occurs, in ammatory cells diffuse and in ltrate the lungs, pulmonary capillary permeability increases, pulmonary tissue is severely edematous, airway and pulmonary vascular resistance increase, and ventilatory insu ciency and hypoxemia occur [26] .…”

Impact of chronic obstructive pulmonary disease in patients undergoing coronary artery bypass graft surgery

“…Ведущей причиной послеоперационной заболеваемости остаются бронхолегочные осложнения. Сообщалось, что у больных, перенесших кардиохирургические операции, смерть, вызванная респираторными ослож- Дыхательная дисфункция является одной из самых частых и тяжелых осложнений послеоперационного периода и связана с повышенной смертностью [28,29]. У пациентов после кардиохиругических оперативных вмешательств наблюдается снижение всех показателей функции легких, особенно таких параметров дыхания как объемные показатели: форсированная жизненная емкость легких (ФЖЕЛ), жизненная емкость вдоха (ЖЕЛ) и интегральный показатель бронхиальной проходимости -ОВФ 1 .…”