Abstract: Objective To evaluate the effect of ulinastatin on brain injury caused by deep hypothermic low-flow cardiopulmonary bypass(CPB) cardiac surgery in piglets. Methods 15 general-type piglets were divided into ulinastatin group (group U, n = 5), control group (group C, n = 5) and sham operation group (group S, n = 5), randomly. Routine CPB was established after median thoracotomy in group U and C under anesthesia. When the temperature of piglets dropped to 25 ℃, low-flow CPB (50ml.kg-1.min-1)began. After 120min of aortic cross-clamping, the aortic was declamped and finally weaned from CPB. Brain hippocampus tissue was harvested following 120min after CPB ceased, then the piglet was killed. 12,000 IU.kg-1 of ulinastatin was given instantly when CPB began and aortic declamp in group U respectively, and group C received equivalently normal saline. Brain hippocampus tissue was harvested after anesthesia and median thoracotomy in group S. Venous blood samples were taken immediately after anesthesia induction (T1) in all groups, 5min(T2) and 120min(T3) after the CPB shutdown in both Group U and C, and neuron-specific enolase (NSE), S100 protein β subtypes (S100β) and myelinbasicprotein (MBP) were tested by ELISA method. Pathology results of hippocampus were observed by light microscopy, and their water content were also measured. Results Totally 15 piglets got complete experiment end. In group C, compared with T1 timepoint, NSE, S100β, MBP were significantly increased by 30.2%, 32.3%, 62.0% and 33.1%, 29.8%, 57.1% in T2, T3 timepoints respectively(P <0.05). Compared with group C,NSE, S100β, MBP were significantly decreased by 16.8%, 7.3%, 20.4% and 20.4%, 2.7%, 18.5% respectively, in T2 and T3 timepoints in group U. (P <0.05). Brain injury was observed in both group U and C, and was lighter in group U. The water content of hippocampus was increased by 2.2% in group C than that of group U (P <0.05). Conclusions Deep hypothermic low-flow cardiopulmonary bypass surgery would result in brain injury on piglets, and ulinastatin could inhibit against those injury.
|