[Effect of ulinastatin (UL) on renal function and lactic acidosis during open-heart surgery: comparison with aprotinin (Ap)].
Comparison was made on the renal function and lactic acidosis during cardiopulmonary bypass (CPB) between the group Ul (n = 15) and group Ap (n = 27). A 300,000 u, of ulinastatin was administered intravenously before CPB and 300,000 u, in the prime solution. A 300,000 u, of aprotinin was administered in the prime solution. Urine output during CPB was not significantly different, but the total dose of furosemide administered was less in group Ul and a significant difference (p less than 0.05) was observed in the free water clearance at CPB 1 hr. and 3 hr. postoperatively, -0.83 +/- 0.16 and -1.74 +/- 0.14 in group Ul and -0.43 +/- 0.10, -0.99 +/- 0.14 in group Ap, respectively. Arterial lactate increased as the perfusion time increased but the level at the end of CPB was significantly lower (p less than 0.05) in group Ul and the added 7% NaHCO3 to correct metabolic acidosis during CPB of 29.3 +/- 9.5 ml in group Ul was less than in group Ap of 82.2 +/- 15.2 ml (p less than 0.01). The result suggests the favourable effects of ulinastatin on the renal function and lactic acidosis during CPB.