Effect of a polymorphonuclear elastase inhibitor (sivelestat sodium) on acute lung injury after cardiopulmonary bypass: findings of a double-blind randomized study.
OBJECTIVE
We evaluated the effect of sivelestat sodium (SiV), a novel synthesized polymorphonuclear (PMN) elastase inhibitor, on acute lung injury (ALI) caused by cardiopulmonary bypass (CPB).


METHODS
Fourteen patients who underwent cardiopulmonary surgery using CPB, followed by the development of both systemic inflammatory response syndrome (SIRS) and ALI, were treated with either 0.2 mg/kg per hour SiV (SiV group, n = 7) or saline (control group, n = 7) for 4 days from the time of arrival in the intensive care unit.


RESULTS
The SiV group had a significantly lower ratio of serum PMN elastase and interleukin (IL)-8, a significantly lower ratio of the respiratory index, and a significantly higher ratio of PaO(2)/FiO(2) after 24 h of treatment than the control group.


CONCLUSIONS
Sivelestat sodium suppressed the production of PMN elastase and IL-8, resulting in improved respiratory function in patients with ALI caused by CPB.
Ryugo
Masahiro
M
Division of Cardiovascular Surgery, Department of Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Sawa
Yoshiki
Y
Takano
Hiroshi
H
Matsumiya
Goro
G
Iwai
Shigemitsu
S
Ono
Masamichi
M
Hata
Hiroki
H
Yamauchi
Takashi
T
Nishimura
Masaji
M
Fujino
Yuji
Y
Matsuda
Hikaru
H
D000208:Acute Disease; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D016209:Interleukin-8; D019272:Leukocyte Elastase / Q000037:antagonists & inhibitors*; D008297:Male; D008875:Middle Aged; D010477:Perfusion / Q000009:adverse effects; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000517:prevention & control; D015842:Serine Proteinase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D013449:Sulfonamides / Q000494:pharmacology* / Q000627:therapeutic use; D018746:Systemic Inflammatory Response Syndrome / Q000517:prevention & control
D016209:Interleukin-8; D015842:Serine Proteinase Inhibitors; D013449:Sulfonamides; C069195:sivelestat; D019272:Leukocyte Elastase; D005998:Glycine