Ulinastatin treatment mitigates glycocalyx degradation and associated with lower postoperative delirium risk in patients undergoing cardiac surgery: a multicentre observational study
Critical Care,
Год журнала:
2025,
Номер
29(1)
Опубликована: Янв. 29, 2025
Abstract
Background
Ulinastatin
(UTI),
recognized
for
its
anti-inflammatory
properties,
holds
promise
patients
undergoing
cardiac
surgery.
This
study
aimed
to
investigate
the
relationship
between
intraoperative
UTI
administration
and
incidence
of
delirium
following
Methods
A
retrospective
analysis
was
performed
on
a
cohort
6,522
adult
surgery
evaluate
treatment
incident
postoperative
(POD)
in
ongoing
followed
by
prospective
observational
241
an
vitro
explore
findings
potential
role
preventing
ischemia–reperfusion
induced
glycocalyx
degradation.
Results
Both
univariate
multivariate
logistic
regression
analyses
indicated
that
associated
with
significant
lower
risk
POD
among
patients,
finding
confirmed
through
employing
propensity
score
matching.
The
subsequent
further
supported
these
(adjusted
Odds
Ratio
=
0.392,
95%
CI:
0.157–0.977,
P
0.044).
Furthermore,
mitigated
degradation,
as
demonstrated
study.
Conclusions
may
mitigate
potentially
lowering
offering
valuable
insights
future
interventions
prevent
enhance
patient
outcomes.
Trial
registration
number
ClinicalTrials.gov
(No.
NCT06268249).
Retrospectively
registered
4
February
2024.
Язык: Английский
Novel Insights into the Kallikrein–Kinin System in Fulminant Myocarditis: Physiological Basis and Potential Therapeutic Advances
Journal of Inflammation Research,
Год журнала:
2024,
Номер
Volume 17, С. 7347 - 7360
Опубликована: Окт. 1, 2024
Fulminant
myocarditis
(FM)
is
characterized
by
rapid
cardiac
deterioration
often
instigated
an
inflammatory
cytokine
storm.
The
kallikrein-kinin
system
(KKS)
a
metabolic
cascade
known
for
releasing
vasoactive
kinins,
such
as
bradykinin-related
peptides,
possessing
diverse
pharmacological
activities
that
include
inflammation,
regulation
of
vascular
permeability,
endothelial
barrier
dysfunction,
and
blood
pressure
modulation.
type
1
2
bradykinin
receptors
(B1R
B2R),
integral
components
the
KKS
system,
mediate
primary
biological
effects
kinin
peptides.
This
review
aims
to
offer
comprehensive
overview
mechanisms
in
FM,
including
examination
structural
components,
regulatory
activation,
downstream
signaling
pathways
KKS.
Furthermore,
it
explores
involvement
tissue
kallikrein/B1R/inducible
nitric
oxide
synthase
(TK/B1R/iNOS)
pathway
myocyte
modulation
immune
response,
preservation
integrity.
potential
therapeutic
advances
targeting
inhibition
managing
FM
will
be
discussed,
providing
valuable
insights
development
clinical
treatment
strategies.
Язык: Английский