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Ulinastatin, et proteasehæmmende lægemiddel med antiinflammatoriske egenskaber, undersøges for sin rolle efter akut type A aorta dissektion (ATAAD) kirurgi i en randomiseret kontrolleret undersøgelse (PANDA) [Cell Rep Med. 2025]. Resultaterne viser, at ulinastatin kan reducere systemisk inflammatorisk respons syndrom (SIRS), men har ikke en signifikant effekt på organsvigt.

Studiet anvendte et randomiseret kontrolleret design med patienter, der gennemgik ATAAD kirurgi. Deltagerne blev opdelt i to grupper: en interventionsgruppe, der modtog ulinastatin, og en kontrolgruppe, der fik standardbehandling. Formålet var at evaluere ulinastatins beskyttende effekt mod inflammatoriske reaktioner og organsvigt.

Det primære endepunkt var den gennemsnitlige daglige Sequential Organ Failure Assessment (SOFA) score fra baseline til 7 dage postoperativt, som var 8,80 (SD, 4,11) i ulinastatin-gruppen og 8,61 (SD, 4,47) i kontrolgruppen (p = 0,765). Der blev observeret en signifikant lavere forekomst af SIRS i ulinastatin-gruppen sammenlignet med kontrolgruppen (p < 0,001). Undersøgelsen indikerer, at tilføjelsen af ulinastatin til standardbehandlingen kan reducere SIRS-rater, men ikke nødvendigvis forebygge organsvigt. Dette er en AI-genereret oversættelse og opsummering. Læseren bør konsultere den originale kilde for validering og ikke træffe kliniske beslutninger udelukkende på baggrund af dette resumé. #Kardiologi #Karkirurgi #Anæstesiologi Læs hele studiet her: [source_link]
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**Title:**
Protective Effects of Ulinastatin Against Inflammatory Response in Acute Type A Aortic Dissection Surgery: Results from the PANDA Trial

**Citation:**
Liu, H., Qian, S.-C., Zhu, K., Diao, Y.-F., Xu, X.-F., Tang, Z.-W., Fan, G.-L., Yue, H.-H., Chen, J.-Q., Yang, J.-N., Zhang, Y.-Y., Ma, C., Liu, X., Wu, Y., Wu, Z., Liu, N., Li, A., Ni, B.-Q., Shao, Y.-F., Zhao, S., Li, H.-Y., Zhang, H.-J. (2025). Ulinastatin in Acute Type A Aortic Dissection Surgery: A Randomized Controlled Trial. *Cell Reports Medicine*, 6(1), 101888. doi:10.1016/j.xcrm.2024.101888

**Authors:**
Hong Liu, Si-Chong Qian, Kai Zhu, Yi-Fei Diao, Xiu-Fan Xu, Zhi-Wei Tang, Guo-Liang Fan, Hong-Hua Yue, Jun-Quan Chen, Ji-Nong Yang, Ying-Yuan Zhang, Chao Ma, Xiang Liu, Ying Wu, Zhong Wu, Nan Liu, Ao Li, Bu-Qing Ni, Yong-Feng Shao, Sheng Zhao, Hai-Yang Li, Hong-Jia Zhang

**Affiliations:**
1. Department of Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
2. Department of Cardiovascular Surgery, National Clinical Research Center for Cardiovascular Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
3. Department of Critical Care Medicine, Shanghai East Hospital, Tongji University, Shanghai, China
4. Department of Cardiovascular Surgery, West China Hospital of Sichuan University, Chengdu, China
5. Department of Cardiovascular Surgery, Tianjin Chest Hospital, Tianjin Medical University, Tianjin, China
6. Department of Cardiovascular Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
7. Department of Cardiovascular Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
8. Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, China
9. Department of Cardiothoracic Surgery, National Regional Medical Center, Suqian Hospital of Nanjing Medical University, Suqian, China
10. School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China

**Abstract:**
Ulinastatin is a protease-inhibiting drug with anti-inflammatory and other pharmacological properties. This randomized controlled trial investigates the protective effect of ulinastatin against negative inflammatory response and organ dysfunction following acute type A aortic dissection (ATAAD) surgery (PANDA). The primary outcome of mean daily Sequential Organ Failure Assessment (SOFA) score from baseline to 7 days post-surgery was 8.80 (SD, 4.11) in the ulinastatin group and 8.61 (SD, 4.47) in the control group (mean difference 0.04; 95% CI, -0.24 to 0.33; p = 0.765). The incidence of systemic inflammatory response syndrome (SIRS) within 7 days of surgery was significantly lower in the ulinastatin group compared to the control group (p < 0.001). While additional ulinastatin treatment likely reduces SIRS rates, it does not prevent organ dysfunction, emphasizing the importance of anti-inflammatory pharmacotherapeutics. The trial is registered on clinicaltrials.org (NCT04711889). **Keywords:** mortality; systemic inflammatory response syndrome; type A aortic dissection; ulinastatin **Publication Types:** Randomized Controlled Trial **MeSH Terms:** Aged; Aortic Dissection* / surgery; Female; Glycoproteins* / pharmacology; Glycoproteins* / therapeutic use; Humans; Inflammation / drug therapy; Male; Middle Aged; Multiple Organ Failure* / prevention & control; Systemic Inflammatory Response Syndrome* / drug therapy; Systemic Inflammatory Response Syndrome* / prevention & control **Substances:** Ulinastatin; Glycoproteins **PMID:** 39842406 --- This structured summary captures the essential details regarding the study and can be utilized for documentation or research purposes. [item_link]

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