Improvement of Sepsis Prognosis by Ulinastatin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
BackgroundUlinastatin has been prescribed to treat sepsis. However, there is doubt regarding the extent of any improvement in outcomes to guide future decision making.ObjectivesTo evaluate the effects of ulinastatin on mortality and related outcomes in sepsis patients.MethodsThirteen randomized cont...
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| Format: | Article |
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Frontiers Media S.A.
2019-11-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphar.2019.01370/full |
| _version_ | 1818253052896870400 |
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| author | Huifang Wang Bin Liu Ying Tang Ping Chang Lishuai Yao Bo Huang Robert F. Lodato Zhanguo Liu |
| author_facet | Huifang Wang Bin Liu Ying Tang Ping Chang Lishuai Yao Bo Huang Robert F. Lodato Zhanguo Liu |
| author_sort | Huifang Wang |
| collection | DOAJ |
| description | BackgroundUlinastatin has been prescribed to treat sepsis. However, there is doubt regarding the extent of any improvement in outcomes to guide future decision making.ObjectivesTo evaluate the effects of ulinastatin on mortality and related outcomes in sepsis patients.MethodsThirteen randomized controlled trials and two prospective studies published before September 1, 2018, that included 1358 patients with sepsis, severe sepsis, or septic shock were evaluated. The electronic databases searched in this study were PubMed, Medline, Embase, and China National Knowledge Infrastructure (CNKI) for Chinese Technical Periodicals.ResultsUlinastatin significantly decreased the all-cause mortality {odds ratio (OR) = 0.48, 95% confidence interval (CI) [0.35, 0.66], p < 0.00001, I2 = 13%}, Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) score {mean difference (MD) = -3.18, 95%CI [-4.01, -2.35], p < 0.00001, I2 = 33%, and reduced the incidence of multiple organ dysfunction syndrome (MODS) (OR = 0.3, 95% CI [0.18, 0.49], p < 0.00001, I2 = 0%). Ulinastatin also decreased the serum levels of IL-6 (MD = -53.00, 95% CI [-95.56, -10.05], p = 0.02), TNF-a MD = -53.05, 95%CI [-68.36, -37.73], p < 0.00001, and increased the serum levels of IL-10 (MD = 37.73, 95% CI [16.92, 58.54], p = 0.0004). Ulinastatin administration did not lead to any difference in the occurrence of adverse events.ConclusionsUlinastatin improved all-cause mortality and other related outcomes in patients with sepsis or septic shock. The results of this meta-analysis suggest that ulinastatin may be an effective treatment for sepsis and septic shock. |
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| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-12T16:33:57Z |
| publishDate | 2019-11-01 |
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| spelling | doaj.art-e5c657adea0f4aa8b569d83bd237aa5f2022-12-22T00:18:43ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122019-11-011010.3389/fphar.2019.01370457381Improvement of Sepsis Prognosis by Ulinastatin: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsHuifang Wang0Bin Liu1Ying Tang2Ping Chang3Lishuai Yao4Bo Huang5Robert F. Lodato6Zhanguo Liu7Department of Intensive Care Unit, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaEmergency Department, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Intensive Care Unit, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Intensive Care Unit, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Thoracic and Cardiovascular Surgical, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Intensive Care Unit, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Pulmonary, Critical Care, and Sleep Medicine, Medical School, University of Texas Health Science Center at Houston, TX, United StatesDepartment of Intensive Care Unit, Zhujiang Hospital, Southern Medical University, Guangzhou, ChinaBackgroundUlinastatin has been prescribed to treat sepsis. However, there is doubt regarding the extent of any improvement in outcomes to guide future decision making.ObjectivesTo evaluate the effects of ulinastatin on mortality and related outcomes in sepsis patients.MethodsThirteen randomized controlled trials and two prospective studies published before September 1, 2018, that included 1358 patients with sepsis, severe sepsis, or septic shock were evaluated. The electronic databases searched in this study were PubMed, Medline, Embase, and China National Knowledge Infrastructure (CNKI) for Chinese Technical Periodicals.ResultsUlinastatin significantly decreased the all-cause mortality {odds ratio (OR) = 0.48, 95% confidence interval (CI) [0.35, 0.66], p < 0.00001, I2 = 13%}, Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) score {mean difference (MD) = -3.18, 95%CI [-4.01, -2.35], p < 0.00001, I2 = 33%, and reduced the incidence of multiple organ dysfunction syndrome (MODS) (OR = 0.3, 95% CI [0.18, 0.49], p < 0.00001, I2 = 0%). Ulinastatin also decreased the serum levels of IL-6 (MD = -53.00, 95% CI [-95.56, -10.05], p = 0.02), TNF-a MD = -53.05, 95%CI [-68.36, -37.73], p < 0.00001, and increased the serum levels of IL-10 (MD = 37.73, 95% CI [16.92, 58.54], p = 0.0004). Ulinastatin administration did not lead to any difference in the occurrence of adverse events.ConclusionsUlinastatin improved all-cause mortality and other related outcomes in patients with sepsis or septic shock. The results of this meta-analysis suggest that ulinastatin may be an effective treatment for sepsis and septic shock.https://www.frontiersin.org/article/10.3389/fphar.2019.01370/fullsepsisulinastatinmortalityinflammatory cytokineimmune system |
| spellingShingle | Huifang Wang Bin Liu Ying Tang Ping Chang Lishuai Yao Bo Huang Robert F. Lodato Zhanguo Liu Improvement of Sepsis Prognosis by Ulinastatin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Frontiers in Pharmacology sepsis ulinastatin mortality inflammatory cytokine immune system |
| title | Improvement of Sepsis Prognosis by Ulinastatin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full | Improvement of Sepsis Prognosis by Ulinastatin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Improvement of Sepsis Prognosis by Ulinastatin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Improvement of Sepsis Prognosis by Ulinastatin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_short | Improvement of Sepsis Prognosis by Ulinastatin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_sort | improvement of sepsis prognosis by ulinastatin a systematic review and meta analysis of randomized controlled trials |
| topic | sepsis ulinastatin mortality inflammatory cytokine immune system |
| url | https://www.frontiersin.org/article/10.3389/fphar.2019.01370/full |
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