Please select the eligibility criteria that correspond to the clinical trial below.
Title: Hemostatic Effects of Ulinastatin and Tranexamic Acid in Cardiac Surgery With Cardiopulmonary Bypass: A Pilot Study
Brief Summary: Antifibrinolytic drugs are used to decrease perioperative bleeding and allogeneic transfusions. The extensively studied antifibrinolytic drug aprotinin is efficacious but expensive, and has been proved to link to higher risks of serious side effects including renal problems, myocardial events, and strokes in patients undergoing CABG. After the secession of aprotinin in 2007, a marked increase of blood loss and transfusions in cardiac surgery took place. An effective and secure hemostatic agent is badly needed. Ulinastatin, urinary trypsin inhibitor(UTI), is a secreted Kunitz-type protease inhibitor with a wide inhibition spectrum, including plasmin. Limited studies offered clues to its antifibrinolytic effect. Tranexamic acid has been applied for years with convinced efficacy and safety. The objective of the study is to evaluate the hemostatic effect of ulinastatin and tranexamic acid in cardiac surgery.


Options:
A: Inclusion Criteria:

* Atrial or ventricular septum defect patients requiring cardiac surgery with CPB
* Rheumatic or recessive valvular patients requiring valvular repair or replacement with CPB
* Coronary artery disease patients requiring coronary revascularization surgery with CPB

Exclusion Criteria:

* Non-primary cardiac surgery
* Definite liver or renal dysfunction
* Disorder in coagulation function
* Allergy
* Pregnancy or lactation
* Disabled in spirit or law
* Fatal conditions such as tumour
B: Inclusion Criteria:

1. Subjects, 18 to 80 years of age, scheduled for elective CABG requiring CPB
2. For female subjects, the following conditions must be met:

postmenopausal for at least 1 year, or status-post surgical sterilization, or if of childbearing potential, utilizing adequate birth control and willing to undergo urine beta-hcg testing prior to drug treatment and on every study day

Exclusion Criteria:

1. Evidence of coagulopathy (INR greater than 1.7 without warfarin therapy)
2. Preoperative hematocrit less than 30%
3. Preoperative platelet count less than 100X109ml-1
4. GPIIb/IIIa antagonist within 48 hours of surgery
5. Emergency surgery
6. Impaired renal function (serum creatinine \>1.6 mg/dl)
7. Pregnancy
8. Breast-feeding
9. Any underlying or acute disease requiring regular medication which could possibly pose a threat to the subject or make implementation of the protocol or interpretation of the study results difficult
10. History of alcohol or drug abuse
11. Treatment with any investigational drug in the 1 month preceding the study
12. Mental conditions rendering the subject unable to understand the nature, scope and possible consequences of the study
13. Inability to comply with the protocol, e.g. uncooperative attitude and unlikelihood of completing the study
C: Inclusion Criteria:

* patients with infective endocarditis (according to DUKE criteria) undergoing cardiac surgery
* informed consent
* age ≥18 years

Exclusion Criteria:

* EuroScoreII ≤ 3
* current participation in another interventional Trial
* pregnancy
* current immunosuppressive or immunomodulatory therapy (with dosing of glucocorticoids over Cushing threshold)
* previous participation in the REMOVE study
D: Inclusion Criteria:

* Indication for coronary surgery established on the basis of current published guidelines

Exclusion Criteria:

* Documented preoperative systemic proinflammatory status and/or steroid administration within 6 months before surgery.
* Coexistence of a cardiomyopathy different than coronary artery disease that precise surgical treatment.
* Left ventricle ejection fraction of 40% or less.
* Treatment with erythropoietin (EPO) three months before the intervention
* Hematocrit less than 35% the day prior to the procedure
* Redo surgery

Answer: A