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[Effects of ulinastatin on coagulation in children after cardiopulmonary bypass]
Peng Huang1, Ping-Bo Liu, Jin-Wen Luo
1Department of Cardiothoracic surgery, Hunan Children's Hospital, Changsha, China. hp_911@sohu.com
Insights
Ulinastatin administration prolonged prothrombin time (PT) and activated partial thromboplastin time (APTT) in children undergoing open-heart surgery. This suggests ulinastatin impacts coagulation following cardiopulmonary bypass (CPB).
Area of Science:
- Pediatric surgery
- Cardiovascular surgery
- Coagulation science
Background:
- Open-heart surgery with cardiopulmonary bypass (CPB) can significantly affect a child's coagulation system.
- Understanding agents that modulate coagulation during CPB is crucial for patient safety and outcomes.
Purpose of the Study:
- To investigate the effects of ulinastatin on coagulation parameters in pediatric patients undergoing open-heart surgery with CPB.
- To determine if ulinastatin influences prothrombin time (PT) and activated partial thromboplastin time (APTT) post-CPB.
Main Methods:
- A randomized study involving 50 children with ventricular septal defect undergoing open-heart surgery.
- Ulinastatin was administered in the CPB priming fluid for the treatment group; a control group received no ulinastatin.
- Coagulation tests including PT, APTT, thrombin time (TT), fibrinogen, and international normalized ratio (INR) were measured at baseline and at 1, 6, and 24 hours post-CPB.
Main Results:
- Prothrombin time (PT) was significantly prolonged in the ulinastatin group compared to the control group at 1 hour (18.7 ± 0.7 s vs 15.5 ± 0.5 s) and 6 hours (17.5 ± 0.6 s vs 15.0 ± 0.6 s) post-CPB.
- Activated partial thromboplastin time (APTT) was also significantly prolonged in the ulinastatin group at 6 hours (38.7 ± 3.1 s vs 35.3 ± 3.1 s) and 24 hours (34.2 ± 3.0 s vs 31.1 ± 2.6 s) post-CPB.
Conclusions:
- Ulinastatin administration appears to prolong both PT and APTT in children after open-heart surgery with CPB.
- These findings indicate that ulinastatin affects the coagulation profile in pediatric patients undergoing CPB.
Objective:
To study the effects of ulinastatin on coagulation in children who underwent open-heart surgery with cardiopulmonary bypass (CPB).
Methods:
Fifty children who underwent open-heart surgery for ventricular septal defect were randomly divided into two groups: ulinastatin treatment and control. Before CPB, ulinastatin (1.0×10(4) U/kg) was added to CPB priming fluid only in the ulinastatin treatment group. Activated partial thromboplasin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen and international normalized ratio (INR) were measured both before and at 1 hr, 6 hrs and 24 hrs after CPB.
Results:
The PT in the ulinastatin group was more prolonged than in the control group at 1 hr after CPB (18.7 ± 0.7 s vs 15.5 ± 0.5 s) and 6 hrs after CPB (17.5 ± 0.6 s vs 15.0 ± 0.6 s). The APTT in the ulinatatin group was also significantly more prolonged than in the control group at 6 hrs after CPB (38.7 ± 3.1 s vs 35.3 ± 3.1 s) and 24 hrs after CPB (34.2 ± 3.0 s vs 31.1 ± 2.6 s).
Conclusions:
Ulinastatin may prolong PT and APTT after CPB, and thus affects coagulation in children.
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