Abstract
The aim of this study is to evaluate whether repeated lung recruitment combined with ulinastatin provides enhanced respiratory compliance and lung oxygenation in children who have undergone the correction of various congenital heart defects through right vertical infra-axillary thoracotomy (RVIAT). All eligible children were those with a common congenital heart defect corrected via an approach through RVIAT. 78 children were randomly classified into four groups: In group A (n = 20), immediately after the end of cardiopulmonary bypass, alveolar recruitment maneuver (ARM) was achieved. In group U (n = 20), children in whom ulinastatin (10,000 U/kg followed by 5,000 U/kg/h) was administered. In group U + A (n = 19), children were intravenously infused with ulinastatin and alveolar recruitment maneuver. And in group C (n = 19) did not accept any additional interventions during surgery. The ARM group tolerated open lung ventilation without significant hemodynamic instability. Compared to controls, intraoperative PaO2, PaO2/FiO2 and oxygen saturation improved in the group A (P<0.05) and group U showed a significantly lower IL-6 (P<0.05). In addition, group A, group U and group A + U had a lower incidence of lung injury and lung atelectasis than Group C after post-CPB time points. Our findings provide some insight that the application of ARM and ulinastatin could effectively provide a better oxygenation profile and pulmonary complication in children with a common congenital heart defect corrected via an approach through RVIAT.