Clinical effects of a neutrophil elastase inhibitor, sivelestat, in patients with acute respiratory distress syndrome.
OBJECTIVE
We assessed the effects of a neutrophil elastase inhibitor, sivelestat, on respiratory and organ functions as well as on the mortality of patients with acute respiratory distress syndrome (ARDS) associated with systemic inflammatory response syndrome (SIRS).


METHODS
We retrospectively divided 25 patients who fulfilled the diagnostic criteria for SIRS and ARDS into two groups. One group (S group, n = 12) received a continuous infusion of sivelestat (0.2 mg.kg(-1).h(-1)), and the other did not (C group, n = 13).


RESULTS
Between days 1 and 10, the Pa(O2)/FI(O2) ratio in the S group significantly improved from 119.1 +/- 51.1 to 214.4 +/- 88.2 mmHg (P < 0.05). Furthermore, the S group spent significantly fewer days on a ventilator than the C group (16.7 +/- 5.8 vs 26.6 +/- 14.3 days; P < 0.05). The length of the intensive care unit stay was also significantly shorter for the S group than for the C group (18.7 +/- 4.9 vs 27.5 +/- 13.5 days; P < 0.05). However, the mortality rate at 29 days did not statistically differ between the two groups.


CONCLUSIONS
Our results suggested that sivelestat has a beneficial effect only on the pulmonary function of ARDS patients with SIRS.
Okayama
Naoko
N
Department of Anesthesiology & Critical Care Medicine, Kagoshima University School of Medicine and Dentistry, 8-35-1 Sakuragaoka, Kagoshima 890-0036, Japan.
Kakihana
Yasuyuki
Y
Setoguchi
Daisuke
D
Imabayashi
Toru
T
Omae
Takeshi
T
Matsunaga
Akira
A
Kanmura
Yuichi
Y
D000368:Aged; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D019272:Leukocyte Elastase / Q000037:antagonists & inhibitors*; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy* / Q000401:mortality
D015842:Serine Proteinase Inhibitors; D013449:Sulfonamides; C069195:sivelestat; D019272:Leukocyte Elastase; D005998:Glycine