The effect of ulinastatin on kidney injury caused by deep hypothermic low-flow cardiopulmonary bypass surgery in piglets
1.Department of Anesthesiology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027; 2.Department of Anesthesiology, Fuwai Cardiovascular Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037; 3.Department of Cardiopulmonary Bypass, Fuwai Cardiovascular Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037; 4.Department of Thoracic and Cardiovascular Surgery, Fuwai Cardiovascular Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037
WANG Xiaocou1,XUE Qinghua2,YAN Fuxia2, et al. The effect of ulinastatin on kidney injury caused by deep hypothermic low-flow cardiopulmonary bypass surgery in piglets[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2014, 44(7): 476-.
Abstract：Objective: To evaluate the effect of ulinastatin on kidney injury caused by deep hypothermic low-flow cardiopulmonary bypass surgery in piglets. Methods: Fifteen Beijing Landrace piglets were divided into ulinastatin group (Group U, n=5), control group (Group C, n=5) and sham operation group (Group S, n=5), randomly. Routine CPB was established after anesthetized and median thoracotomy in group U and C. When the temperature of piglets dropped to 25 ℃, low-flow CPB (50 mL · kg-1 · min-1) began. After 120 min of aortic cross-clamping, the circulation was reopened and adjusted, finally ceased CPB. Kidney tissue was harvested 120 min after CPB ceased. 12 000 IU · kg-1 of ulinastatin was given instantly when CPB began and circulation reopened respectively in group U, and group C received normal saline equivalently. Kidney tissue was harvested after anesthesia and median thoracotomy in group S. Venous blood samples were taken immediately after anesthesia induction (T1) in all groups, 5min (T2) and 120 min (T3) after the CPB shutdown merely in both Group U and C, for the test of Cystatin C (CysC), Serum SCratinine (SCr), blood urea nitrogen (BUN), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). When the experiment was terminated, test of the urine N-acetyl-β-D-glucosaminidase (NAG) and pathological examination of kidney tissues were performed in all three groups. Results: All 15 piglets completed experiment end. There were no statistics differences of CysC, SCr, BUN, IL-6, and TNF-α in all three groups (P>0.05) in T1 timepoints. Compared with Group C, CysC, SCr, BUN, IL-6, and TNF-α were significantly decreased respectively 12.50% (P>0.05), 2.97% (P>0.05), 0.37% (P>0.05), 26.28% (P<0.05), 10.81% (P<0.05) in T2 timepoints and 24.37% (P<0.05), 17.20% (P<0.05), 16.82% (P<0.05), 18.12% (P<0.05), 8.57% (P>0.05) in T3 timepoints in Group U. Compared with Group C, urine N-acetyl-β-D-glucosaminidase was significantly decreased 51.17% (P<0.05) in Group U. Kidney injury was observed in both Group U and C, and was lighter in group U, but not with Group S. Conclusion: Deep hypothermic low-flow cardiopulmonary bypass surgery will result in kidney injury on piglets, and ulinastatin can inhibit against those injury by inhibiting the inflammatory response.
