Effects of ulinastatin on changes of plasma granulocyte elastase, myeloperoxidase and fibronectin during and after open heart surgery

We investigated effects of ulinastatin on plasma levels of granulocyte elastase in alpha 1-proteinase inhibitor complex, myeloperoxidase and fibronectin in 20 patients during and after open heart surgery. Ulinastatin, 300,000 units were given immediately after the induction of anesthesia. Plasma fibronectin increased significantly after cardiopulmonary bypass (CPB) in ulinastatin group (group U) compared with control (group C) group. Regression coefficients between CPB time and changes of plasma fibronectin in group U were significantly different from those in group C after CPB. Plasma levels of granulocyte elastase in alpha 1-proteinase inhibitor complex were not different between the two groups. Regression coefficients of group U were smaller than those of group C after CPB. Plasma levels of myeloperoxidase were not different between the two groups. Regression coefficients of group U were significantly smaller than those of group C. Ulinastatin suppressed significantly the decrease of plasma fibronectin after CPB. Ulinastatin had no effects on plasma granulocyte elastase in alpha 1-proteinase inhibitor complex during and after CPB. Ulinastatin inhibited the increase of plasma myeloperoxidase in proportion to CPB time.