Continuous infusion of high-dose ulinastatin during surgery does not improve early postoperative clinical outcomes in patients undergoing radical lung cancer surgery: A pilot study

Thorac Cancer. 2016 Sep;7(5):581-587. doi: 10.1111/1759-7714.12371. Epub 2016 Jun 13.

Abstract

Background: Ulinastatin can prevent the perioperative increase in proinflammatory cytokines for lung resection surgery; however, its impact on early clinical outcomes remains unknown.

Methods: The study enrolled 108 non-small cell lung cancer (NSCLC) patients who were randomly allocated into two groups: ulinastatin (group U) and control (group C). Patients in group U ( n = 52) were continuously intravenously infused with ulinastatin at a rate of 20 000 U/kg/hour for the first hour after anesthesia induction, and then at a rate of 5000 U/kg/hour until the conclusion of surgery. Patients in group C ( n = 56) received an equivalent volume of normal saline. The primary outcome was to record the postoperative pulmonary complications that occurred during hospital stay. Other clinical courses, such as hospital mortality, blood loss, respiratory parameters, postoperative chest drainage, and duration of intensive care unit and postoperative hospital stay, were also observed and analyzed.

Results: There were no significant differences between the two groups in early postoperative pulmonary complications, hospital mortality, blood loss, or other perioperative laboratory values, except for the duration of postoperative chest drainage and serum creatinine level. The frequency of pulmonary complications was lower in patients treated with ulinastatin compared with the control (38.46% in group U vs. 48.21% in group C).

Conclusion: Administration of high-dose ulinastatin during surgery did not reduce postoperative pulmonary complications, hospital mortality, or hospital stay for patients undergoing lung radical thoracotomy. However, a protective trend of ulinastatin was observed.

Keywords: Non-small cell lung cancer; postoperative pulmonary complications; thoracotomy; ulinastatin.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Intravenous
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Cytokines / blood
  • Double-Blind Method
  • Female
  • Glycoproteins / administration & dosage*
  • Glycoproteins / therapeutic use
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Pilot Projects
  • Postoperative Complications / epidemiology
  • Postoperative Complications / immunology
  • Postoperative Complications / prevention & control*
  • Postoperative Period
  • Pulmonary Surgical Procedures / methods
  • Trypsin Inhibitors / administration & dosage*
  • Trypsin Inhibitors / therapeutic use

Substances

  • Cytokines
  • Glycoproteins
  • Trypsin Inhibitors
  • urinastatin