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J Korean Soc Emerg Med > Volume 20(1); 2009 > Article
Original Article
Journal of The Korean Society of Emergency Medicine 2009;20(1): 80-85.
The Effects of Urinary Trypsin Inhibitor on the Outcomes of Severe Sepsis and Septic Shock Patients
Sung Woo Moon, Sung Woo Lee, Yun Sik Hong, Dae Won Park, Ik Jin Jang, Young Hoon Yoon, Sung Ik Lim
1Department of Emergency Medicine, College of Medicine, Korea University, Seoul, Korea, Division of Infection, Korea. kuedlee@korea.ac.kr
2Department of Internal Medicine, Korea University Ansan Hospital, Kyunggido, Korea.
ABSTRACT
PURPOSE:
We purposed to determine the effects of urinary typsin inhibitor (ulinastatin) on the outcomes of severe sepsis and septic shock patients.
METHODS:
This is a prospective case control study of severe sepsis and septic shock patients who visited emergency department of university hospital from January 2005 to June 2008. For study group, 100,000 U of ulinastatin was initially infused and then additional infusions of ulinastatin were determined by the mean arterial pressure. We compared the predicted mortality and the actual in-hospital mortality between the ulinastatin group and the control group. We also compared the improvement of the SOFA score according to time between the groups.
RESULTS:
There were 43 patients in the ulinastatin group and 126 patients in the control group. The predicted mortality and the actual mortality of the ulinastatin group were 31.2% and 18.6%, respectively. The predicted and actual mortalities of the control group were 33.1% and 27.0%, respectively. The improvement of the SOFA score for the ulinastatin group was 6.8+/-3.9 and 5.0+/-4.5 at 0 and 24 hours (p<0.001), 6.5+/-3.7 and 3.9+/-4.3 at 0 and 48 hours (p<0.001) and, 6.3+/-3.6 and 3.0+/-4.1 at 0 and 72 hours (p<0.001). For the control group, the change of the SOFA score was 4.9+/-2.9 and 5.8+/-4.1 at 0 and 24 hours (p=0.003), 5.0+/-2.8 and 5.1+/-4.2 at 0 and 48 hours (p=0.760) and, 4.8+/-2.7 and 4.34.1 at 0 and 72 hours (p=0.105).
CONCLUSION:
The ulinastatin group showed significantly lower mortality than the predicted mortality and the ulinastatin group's SOFA score was improved in the early hospital days.
Key words: Septic shock, Severe sepsis, Urinary trypsin inhibitor
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