To evaluate whether receipt of ulinastatin in addition to meropenem-based standard care was associated with inflammatory, coagulation, perfusion, and clinical outcomes in patients with severe septic shock.
Approach:
Study Design: Single-center retrospective, non-randomized comparative cohort study.
Participants: 106 consecutive patients with severe septic shock treated between January 2023 and November 2025.
Groups: Patients were classified into two groups: observation group (meropenem + ulinastatin, n = 53) and control group (meropenem alone, n = 53).
The overall response rate in the observation group was higher at 90.6% (48/53) compared to 73.6% (39/53) in the control group (p < 0.05).
Post-treatment, the observation group had lower levels of CRP, PCT, IL-6, IL-8, and TNF-α (p < 0.05).
Post-treatment Fib levels were lower, and PT and APTT were shortened in the observation group (p < 0.05).
Improved hemodynamic parameters (HR, MAP, CI) were noted in the observation group (p < 0.05).
Higher CD4+ T cell counts and CD4+/CD8+ ratios, and lower CD8+ T cell counts were found in the observation group (p < 0.05).
Higher lactate clearance rates at 6 hours and 24 hours in the observation group (p < 0.001).
Shorter ICU stay and mechanical ventilation duration in the observation group (p < 0.001).
The complication rate was 9.4% (5/53) in the observation group, compared to 24.5% (13/53) in the control group (p < 0.05).
Interpretation:
Receipt of ulinastatin in addition to meropenem-based standard care was associated with more favorable outcomes in various clinical parameters.
Limitations:
The study was not randomized.
Residual confounding cannot be excluded.
Conclusion:
Findings suggest that the combination of ulinastatin and meropenem may improve inflammatory, coagulation, and clinical outcomes in severe septic shock patients.
