[Study on extravascular lung water and polymorphonuclear leukocyte elastase during acute phase following radical treatment of lung cancer: effect of ulinastatin on respiratory functions].
We studied respiratory functions, extravascular lung water (EVLW) as measured by a thermodilution method using double Na indicators, and variations in polymorphonuclear leukocyte elastase (PMNE) during the acute phase following radical treatment of lung cancer, as well as to investigate clinical effect of ulinastatin. Using 16 patients with lung cancer who had undergone surgery of R 2 a or more, 10 patients without ulinastatin therapy were compared with six patients given 300,000 U/day of this drug by drip infusion from Day 0 and 4 of disease. It was found that EVLW value decreased most on Day 1, and gradually increased thereafter but did not return to the preoperative level. PMNE value increased from immediately after surgery and peaked on Day 3, but returned nearly to the preoperative level by Day 5. Although this was different from the variations in EVLW value, there was a correlation between these two parameters on Day 3 when PMNE peaked. Further, ulinastatin tended to inhibit PMNE and improve oxygenation index. Respiratory and circulatory parameters vary in complex manners during the acute phase following radical treatment of lung cancer, and could not be accurately evaluated by means of thermodilution using Na. PMNE is considered a contributing factor to pulmonary tissue disorders following radical treatment of lung cancer, and ulinastatin appeared to be effective in the postoperative management of patients undergoing radical treatment of lung cancer.
Kondo
D
D
Department of Thoracic Surgery, Shizuoka Saiseikai Hospital, Japan.
Imaizumi
M
M
Abe
T
T
D000210:Acute-Phase Reaction / Q000188:drug therapy / Q000503:physiopathology*; D000368:Aged; D015633:Extravascular Lung Water / Q000378:metabolism*; D005260:Female; D006023:Glycoproteins / Q000627:therapeutic use*; D006801:Humans; D019272:Leukocyte Elastase; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000201:enzymology; D010196:Pancreatic Elastase / Q000378:metabolism*; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000188:drug therapy / Q000503:physiopathology; D012119:Respiration / Q000187:drug effects*; D014361:Trypsin Inhibitors / Q000627:therapeutic use*
D006023:Glycoproteins; D014361:Trypsin Inhibitors; D010196:Pancreatic Elastase; D019272:Leukocyte Elastase; C028665:urinastatin