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Canadian Journal of Anesthesia, Vol 43, 456-460, Copyright © 1996 by Canadian Anesthesiologists' Society

ARTICLES

Ulinastatin reduces elevation of cytokines and soluble adhesion molecules during cardiac surgery

T Kawamura, K Inada, N Akasaka and R Wakusawa
Department of Anaesthesia, School of Medicine, Iwate Medical University, Japan.

PURPOSE: To investigate whether ulinastatin pretreatment (6000 U.kg-1 before CPB and before declamping of aorta) influenced the production of cytokines and adhesion molecules in the peripheral circulation. METHODS: This prospective randomized study was performed in 22 patients undergoing cardiac surgery. They were divided into two groups. Patients in Group I were untreated and in Group II treated with ulinastatin. The soluble intercellular adhesion molecule-1 (S-ICAM-1), soluble endothelial leukocyte adhesion molecule-1 (S-ELAM-1), interleukin 8 and 6 (IL- 8, 6) were measured using ELISA kits. RESULTS: Serum S-ICAM-1 concentration in Group I increased from the preoperative value of 297 +/- 27 ng.kg-1 to 418 +/- 106 ng.kg-1 at 60 min after declamping of the aorta (P < 0.01) but did not change in Group II. Serum S-ELAM-1 concentration did not change in either group. Serum concentration of IL-8 and IL-6 in Group I (37 +/- 44 pg.kg-1, and 59 +/- 59 pg.kg-1, preoperatively) increased to 169 +/- 86 pg.kg-1 and 436 +/- 143 pg.kg-1 at 60 min after declamping of the aorta (P < 0.001, P < 0.001). The increases were greater than those from 25 +/- 6 pg.kg-1 and 30 +/- 26 pg.kg-1 to 56 +/- 36 pg.kg-1 and 132 +/- 78 pg.kg-1 in Group II (P < 0.001, P < 0.001). The levels of S-ICAM-1 correlated with those of IL-8 (r = 0.5, P < 0.001). CONCLUSION: These results suggest that ulinastatin may suppress the increase in IL-8 production and the expression of ICAM-1 during cardiac surgery.


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Copyright © 1996 by the Canadian Anesthesiologists' Society.