Indications

• Severe sepsis - Sepsis is defined as a systematic inflammatory response syndrome (SIRS) in the presence of, or a result of suspected or proven infection. Severe sepsis is defined as sepsis with one of the following features: cardiovascular organ dysfunction, acute respiratory distress syndrome (ARDS), or dysfunction of two or more organs.
• Mild and severe acute pancreatitis.

Administration and Dosage :

• Administer 1 to 2 vials of 1,00,000 IU of ulinastatin by intravenous infusion over 1 hour each time, 1-3 times per day for 3 to 5 days.
• Dosage of ulinastatin can be based on the patient’s age and the severity of symptoms.
• Ulinastatin 1L IU vial should be reconstituted in 100 ml of dextrose 5% or 100ml of 0.9% normal saline.

To assess the effects of Ulinastatin on mortality and related outcomes in sepsis patients - A Systematic Review and Meta-Analysis of Randomized Controlled Trials

13 RCTs and 2 prospective studies with 1358 patients with sepsis, severe sepsis, or septic shock published before September 2018, were reviewed. In this study, the electronic databases used to search were PubMed, Medline, Embase and CNKI for Chinese Technical Periodicals.

Conclusion

Ulinastatin is associated with reductions in both all-cause mortality and the incidence of MODS, and improvements in both APACHE II scores and inflammatory cytokine profiles in patients with sepsis, severe sepsis or septic shock.

Role of Ulinastatin, a trypsin inhibitor, in severe acute pancreatitis in intensive care unit

Patients were divided into 2 groups based on whether they received ulinastatin or not. The following outcome variables were compared: in-hospital mortality, development of new-onset OD, resolution of existing OD by Day 5, and length of hospital stay.