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

OBJECTIVE: To 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). METHODS: Patients 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 PaO(2)/FiO(2) 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 PaO(2)/FiO(2) ratio was also compared among the time points. RESULTS: Group U showed a significantly higher PaO(2)/FiO(2) ratio (F(4, 89.0) = 657.339) and a lower incidence of lung injury (PaO(2)/FiO(2) ratio < 300) than Group C at the post-CPB and ICU-6 time points. CONCLUSION: High-dose ulinastatin improved pulmonary oxygenation after CPB and in the early stages of the ICU stay in patients undergoing aortic valve surgery with CPB.