• S Wakayama, T Suzuki, T Sakai, and A Matsuki.
• Department of Anesthesia, Aomori Rosai Hospital, Hachinohe.
• Masui. 1990 Jun 1; 39 (6): 734-40.

AbstractTo evaluate the effect of nafamostat mesilate, a potent protease inhibitor, on the pancreatic enzymes and the endocrine system in patients undergoing open-heart surgery with extracorporeal circulation, serum activities of amylase, trypsin, alpha 1-antitrypsin (alpha 1AT) and pancreatic secretory trypsin inhibitor (PSTI), and plasma levels of cortisol and catecholamines were measured. Seven patients (nafamostat group) received intravenous nafamostat mesilate 0.5 mg.kg-1.hr-1 during cardiopulmonary bypass (CPB). The remaining seven patients (non-nafamostat group) did not receive any protease inhibitor. Both groups showed the same changes in serum activities of pancreatic enzymes during CPB. In sera, the levels of amylase, trypsin and alpha 1AT decreased during CPB. Amylase and trypsin activities returned toward the preanesthetic levels after CPB, while alpha 1AT remained at lower levels. PSTI was unchanged during CPB. Plasma cortisol levels markedly increased during and after CPB, but there was no difference between nafamostat group and non-nafamostat group. Nafamostat group showed lower plasma dopamine levels and higher epinephrine levels compared with non-nafamostat group. The result suggests that nafamostat mesilate administered during CPB could not influence the changes in the activities of pancreatic enzymes. Further studies are needed to clarify the effect of this protease inhibitor on the endocrine system.

16 keywords...

hide…