Effects of alprostadil and ufinastatin on protamine-induced pulmonary injury in patients undergoing off-pump coronary artery bypass grafting

Abstract

Objective To investigate the therapeutic effects of alprostadil and ulinastatin on protamine-induced pulmonary injury in patients undergoing off-pump coronary artery bypass grafting(CABG). Methods Sixty patients scheduled to undergoing off-pump CABG were randomly divided into 4 groups:alprostadil group(A,n= 15), ufinastatin group(U,n= 15), AU group receiving alprostadil and ufinastatin(n= 15),and C group(control group,n= 15)receiving normal saline of the equal volume. Plasma neutrophil(PMN), interleukin(IL)- 6, IL- 8, IL- 10, tumor necrosis factor-α(TNF-α)and plasma concentrations of thromboxane B2(TXB2)in the radial arterial blood samples were measured on 5 min before and 15 min after administration of protamine. Blood gas analysis was done and alveolar- arterial oxgen gradiant(A- aDO 2), respiratory index (RI)and oxygenation index(OI) were calculated. Results The number of PMN and levels of IL-6, IL-8, IL-10 and TNF-α at T2 in A, U and AU groups were lower than those in the control group, with the group AU being the lowest(all P< 0.05). The level of TXB2 at T2 in A, U and AU groups was significantly lower than in the control group(P< 0.05) with the group AU being the lowest[(100±17)μg/L,P< 0.05]. The OI at T2 in A, U and AU groups was significantly higher than in control group(P<0.05). The highest OI value existed in AU group[(428±28)mm-Hg,P< 0.05]. Conclusion Alprostadil combined with ufinastatin can inhibit protamine- induced pulmonary injury in patients undergoing off- pump CABG. Key words: Alprostadil; Ulinastatin; Off-pump coronary artery bypass grafting; Protamine; Pulmonary injury