Effect of urinary trypsin inhibitor on inflammatory cytokines and organ function in patients with cardiopulmonary bypass

H.-Y. Xu, X.-S. Rong, D.-P. Wang, S.-Y. Jiang, Z.-D. Zang, W. Xia, F. Zhang, J. Yan

Department of Critical Care Medicine, Department of Cardiovascular Surgery; Affiliated People’s Hospital, Nanjing Medical University, Wuxi, China. hroqs989@sina.com

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• Cardiology

OBJECTIVE: This research is to study the effect of urinary trypsin inhibitor (UTI) on inflammatory cytokines and organ function in patients with cardiopulmonary bypass.

PATIENTS AND METHODS: From February 2015 to February 2016, 40 patients that had undergone cardiopulmonary bypass surgery in our hospital were selected and randomly divided into the observation group and the control group with 20 patients in each group. Patients in the control group were intravenously injected with 5000 U/kg normal saline during the operation and 5000 U/kg•d-1 at 1-3 days postoperatively, while the patients in the observation group received intravenous injection of the same amount of UTI at pre-operation (T0), post-anesthesia (T1), after aortic opening (T2), after cardiopulmonary bypass 4h (T3), 8h (T4), 24h (T5), 48h (T6), and 72h (T7). We detected tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6) and interleukin-8 (IL-8) levels in each group, and compared the pre and post-operative alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), direct bilirubin (DB) and creatinine level in the two groups of patients.

RESULTS: At the time T3, T4, T5, T6, and T7, TNF-α, IL-1β, IL-6, and IL-8 water in the observation group were significantly lower than those in the control group; the difference was statistically significant (p < 0.05). The 24 h postoperative ALT, AST, and TB of two groups were significantly higher than those pre-operatives (p < 0.05). The ALT and AST levels in the observation group were significantly lower than those in the control group after 24 h postoperative (p < 0.05). The 24 h postoperative TB DB of the two groups had not statistically significant differences (p > 0.05). At 24 h postoperative creatinine levels in the two groups were significantly lower than those before operation (p < 0.05), and there was no significant difference between the two groups (p > 0.05). In the observation group, the duration of ventilation and ICU hospitalization time were significantly lower than that in the control group, and the difference was statistically significant (p < 0.05).

CONCLUSIONS: UTI can effectively regulate the inflammatory cytokines and provide protection for organ function during cardiopulmonary bypass surgery, which is conducive to promote the recovery of patients.

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