{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:45:50Z","timestamp":1777445150520,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,2,6]],"date-time":"2013-02-06T00:00:00Z","timestamp":1360108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2013,3]]},"abstract":"Summary<\/jats:title>Objective<\/jats:title>Infants are potentially more susceptible to brain injury mediated via cell death attributed to cardiopulmonary bypass (CPB) especially with prolonged hypothermic low flow (HLF<\/jats:styled-content>). We hypothesized that a human urinary protease inhibitor (ulinastatin), by its anti\u2010inflammatory effect, would reduce central nervous system (CNS<\/jats:styled-content>) injury during HLF<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>Fifteen general\u2010type infant piglets were randomized to ulinastatin group (G<\/jats:styled-content>roup U<\/jats:styled-content>, n<\/jats:italic>\u00a0=\u00a05), control group (G<\/jats:styled-content>roup C<\/jats:styled-content>, n<\/jats:italic>\u00a0=\u00a05), and sham operation group (G<\/jats:styled-content>roup S<\/jats:styled-content>, n<\/jats:italic>\u00a0=\u00a05). Routine CPB was established after median thoracotomy in G<\/jats:styled-content>roup U<\/jats:styled-content> and C<\/jats:styled-content> under anesthesia. When the temperature of infant piglets dropped down to 25\u00b0C, low\u2010flow CPB<\/jats:styled-content> (50\u00a0ml\u00b7kg\u22121<\/jats:sup>\u00b7min\u22121<\/jats:sup>) was instituted. After 120\u00a0min of aortic cross\u2010clamping and 20\u2010 to 30\u2010min rewarming, the aortic cross\u2010clamp was removed and finally the piglet was weaned from CPB<\/jats:styled-content>. Five thousand units per killogram of ulinastatin and equivalently normal saline were, respectively, given at the beginning of and at aortic declamping in G<\/jats:styled-content>roup U<\/jats:styled-content> and G<\/jats:styled-content>roup C<\/jats:styled-content>. Group S<\/jats:styled-content> just received sham median thoracotomy. Venous blood samples were taken immediately after anesthesia induction in all three groups, 5\u2010 and 120\u2010min post CPB<\/jats:styled-content> in both Group U<\/jats:styled-content> and C<\/jats:styled-content>, respectively; plasma markers of inflammation and CNS<\/jats:styled-content> injury were compared. Pathology results of hippocampus were observed by light microscopy.<\/jats:p><\/jats:sec>Results<\/jats:title>Statistically significant differences between Group C<\/jats:styled-content> and U<\/jats:styled-content> were noted in the expression of inflammatory markers such as IL<\/jats:styled-content>\u201010, TNF<\/jats:styled-content>\u2010\u03b1 and neuron\u2010specific enolase at 120\u2010min post CPB<\/jats:styled-content>. Brain injuries were observed in both groups (index cases and controls) and were milder in G<\/jats:styled-content>roup U<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In our study, HLF<\/jats:styled-content> CPB on infant piglets resulted in brain injury, and ulinastatin might reduce the extent of such injury.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12073","type":"journal-article","created":{"date-parts":[[2013,2,6]],"date-time":"2013-02-06T10:03:38Z","timestamp":1360145018000},"page":"209-216","source":"Crossref","is-referenced-by-count":21,"title":["Ulinastatin as a neuroprotective and anti\u2010inflammatory agent in infant piglets model undergoing surgery on hypothermic low\u2010flow cardiopulmonary bypass"],"prefix":"10.1111","volume":"23","author":[{"given":"Xiaocou","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinghua","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuxia","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lihuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiopulmonary Bypass State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoujun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Surgery State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 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