Vascular permeability and hemodynamic effects of ulinastatin on organs affected by shock during early burn injury

Background

This study aimed to investigate the preventive and therapeutic effects of ulinastatin on the recovery of vascular permeability and hemodynamics in shock-affected organs during early burn injury.

Methods

Twelve beagle dogs with 35% TBSA full-thickness burn were randomized to control group (CG, n?=?6) and ulinastatin group (UG, n?=?6).Hemodynamic parameters were determined by PICCO before burn and at 0.5?h, 1?h, 2?h, 4?h, 6?h, 8?h post-burn. Plasma volume (PV) were deduced through indocyanine green (ICG) method. Blood samples were drawn to determine hematocrit (HCT) at each time. Intestinal mucosal blood flow (IMBF) was determined by laser Doppler flowmetry. Evans blue (EB) method was taken to measure the vasopermeability of heart, liver, spleen, kidney and small intestine. Pathological tests were also performed.

Results

Compared with CG,UG had better hemodynamic parameters (improved mean arterial pressure and cardiac output) (P?<?0.05). HCT rose in both groups, while in UG the rising extent was less than that in CG (P?<?0.05). PV and IMBF in both groups declined, but in UG the extent were less (P?<?0.05). Both EB content of liver, spleen, kidney and small intestine in UG were much lower than that in CG at 8?h post-burn (P?<?0.05). Pathological changes showed that severe injury was significantly ameliorated in UG.

Conclusions

Ulinastatin helped to moderate the quick loss of circulatory volume and improved hemodynamic indices in beagle dogs who had suffered 35% third degree burn injuries. It may serve as a therapeutic agent for reducing vascular permeability, thereby preventing fluid loss following major burn injury.