IMPROVEMENT OF ANTI-INFLAMMATORY THERAPY FOR PATIENTS AFTER CORONARY ARTERY BYPASS GRAFTING

Аннотация

An inflammatory response is likely to develop in all cardiac surgical patients operated on with or without cardiopulmonary bypass (CPB). With prolonged cardiac surgery and CPB, clinical manifestations develop in the form of increased capillary permeability, resulting in widespread edema, impaired gas exchange, cerebral, renal and hepatic dysfunctions.In this study, patients were divided into two groups, depending on the use of ulinastatin: group 1 (main) n= 35 patients who used ulinastatin in the intraoperative and early postoperative periods; Group 2 (control) – n = 30 patients who did not use ulinastatin in the intraoperative and early postoperative periods. In the complex of postoperative anti-inflammatory therapy to prevent organ damage and multiple organ dysfunction, it is necessary to include the use of a broad-spectrum protease inhibitor ulinastatin at a dose of 100,000 IU in 500 ml of 5% glucose solution or 0.9% sodium chloride intravenously drip for 1-2 hours on the 1st, 3rd day. Against the background of the use of ulinastatin, there was a decrease in the number of proinflammatory cytokines, in particular IL-6, in patients of the main group by 8±1.6 pg/ml (p<0.05), and in the control group there was an increase in the content of IL-6 by 15±3.6 pg/ml (p>0.05). Thus, the analysis shows a beneficial effect of ulinastatin on mortality, the frequency of postoperative complications, or the duration of stay in the intensive care unit after coronary artery bypass surgery.