• Jun-yuan Wu, Shuo Wang, Chun-sheng Li, and Wei Yuan.
• Department of Emergency, Capital Medical University, Beijing, China.
• Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2013 Feb 1;25(2):106-8.

ObjectiveTo evaluate the effects of ulinastatin (UTI) on improving inflammatory response and myocardial and lung tissue injury after cardiopulmonary resuscitation (CPR) in porcine model.MethodsVentricular fibrillation (VF) was induced in 20 female pigs by programmed stimulation method. CPR was begun 8 minutes after VF. Pigs with recovery of spontaneous circulation (ROSC) were randomly divided into two groups: group UTI, UTI was given immediately after resuscitation, with 100 kU dissolved in 5 ml of normal saline by slow intravenous injection every 3 hours, up to 24 hours after resuscitation. In control group, 5 ml of normal saline was given with same delivery time and frequency as that in the UTI group. Before VF, immediately after ROSC, 3 hours, 12 hours and 24 hours after ROSC, samples of venous blood were collected for examination of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1), using the enzyme-linked immunospecific assay (ELISA) method. The pigs were sacrificed at 24 hours after ROSC for myocardium and lung pathological and ultrastructural examinations.ResultsAmong a total of 20 domestic pigs, 15 pigs were successfully resuscitated after 8-minute VF. Eight pigs in UTI group and 7 pigs in control group survived for 24 hours. Pro-inflammatory factors of the both groups were increased gradually after ROSC. Levels of TNF-α, IL-1β, ICAM-1 and VCAM-1 were not significant different between UTI and control groups before VF and immediately after ROSC. But TNF-α and IL-1β levels were significantly lower in the UTI group than those of the control group beginning from 3 hours after ROSC (TNF-α: 28.79±9.49 ng/L vs. 44.01±17.01 ng/L, IL-1β: 153.50±67.47 ng/L vs. 252.09±80.41 ng/L, both P<0.05); ICAM-1 and VCAM-1 levels were significantly lower in the UTI group than those of the control group from 12 hours after ROSC (ICAM-1: 11.05±5.11 μg/L vs. 17.09±5.69 μg/L, VCAM-1: 11.17±4.75 μg/L vs. 16.62±4.63 μg/L, both P<0.05). The myocardium and lung injuries at 24 hours after ROSC were significantly milder in UTI group than that of the control group.ConclusionUTI can significantly reduce the pro-inflammatory reaction and the extent of myocardial and lung tissue injury after resuscitation.

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