Abstract: Objective To study protective effect of ulinastatin on perioperative cardiac function in elderly patients undergoing
major gastrointestinal surgery. Methods Sixty elderly patients (32 male and 28 female patients) aged 60-82 years scheduled for
major gastrointestinal surgery were randomized into ulinastatin group and control group. The patients in ulinastatin group
received 2 × 105 U ulinastatin rapidly administered via a intravenous pump immediately before operation with subsequent
continuous infusion at the rate of 1×105 U until the completion of surgery, and those in the control group received the same
amount of saline instead. In both groups, the mean arterial pressure (MAP), heart rate (HR), left ventricular ejection fraction
(LVEF), and cardiac output (CO) were monitored immediately before surgery (T0) and at 1 h (T1), 2 h (T2) and 3 h (T3) after the
start of surgery. The total dopamine dose used was recorded at the end of surgery, and blood samples were collected at T0 and
at 6 h (T4) and 12 h (T5) after the operation for determination of serum levels of cTn, CK-MB and BNP. Results In both groups,
MAP, LVEF and CO were significantly decreased at T2 and T3 (P<0.05) and serum levels of cTn, CK-MB and BNP significantly
increased at T4 and T5 compared to those at T0 (P<0.05). Compared with the control group, the patients in ulinastatin group
showed significantly higher MAP, LVEF and CO at T2 and T3 and lower serum levels of cTn, CK-MB and BNP at T4 and T5.
Conclusion Ulinastatin offers effective perioerative cardiac protection in elderly patients undergoing major gastrointestinal
surgery.