[Efficacy of sivelestat for acute lung injury due to severe bacterial pneumonia with systemic inflammatory response syndrome].
OBJECTIVE
Neutrophil elastase is believed to play an important role in acute lung injury (ALI). Sivelestat is a small molecular weight neutrophil elastase inhibitor. Although some authors reported its efficacy in ALI, it is unclear whether sivelestat has good effects in ALI, especially in cases due to severe bacterial pneumonia. The purpose of this study is to investigate the effect of sivelestat to ALI due to severe bacterial pneumonia.


METHODS
We performed a retrospective study of 28 patients who were admitted for severe bacterial pneumonia (pneumonia severity index; PSI class V). We investigated the patients' background, pneumonia severity score, the days from diagnosis of systemic inflammatory response syndrome (SIRS) to sivelestat administration, P/F ratio, SIRS score, and compared two groups: those who survived and those who died.


RESULTS
There were no significant background differences between the two groups. In pneumonia severity score, chest X-ray film score was higher in the group of fatalities than in the survival group. In the survival cases, sivelestat had been administered earlier than in the cases that died. In the survival cases, improvement in P/F ratio, body temperature, heart rate, and respiratory rate were shown. The total number of SIRS scores also decreased in survival cases.


CONCLUSIONS
This study suggested the possibility that early administration of sivelestat may improve the ALI survival rate in severe pneumonia.
Nakamura
Shigeki
S
Second Department of Internal Medicine, Nagasaki University Hospital.
Yanagihara
Katsunori
K
Izumikawa
Koichi
K
Seki
Masafumi
M
Kakeya
Hiroshi
H
Yamamoto
Yoshihiro
Y
Mukae
Hiroshi
H
Tashiro
Takayoshi
T
Kohno
Shigeru
S
D055371:Acute Lung Injury / Q000188:drug therapy* / Q000209:etiology*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005998:Glycine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D019272:Leukocyte Elastase / Q000037:antagonists & inhibitors; D008297:Male; D018410:Pneumonia, Bacterial / Q000150:complications*; D012189:Retrospective Studies; D015842:Serine Proteinase Inhibitors / Q000008:administration & dosage*; D012720:Severity of Illness Index; D013449:Sulfonamides / Q000008:administration & dosage*; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications*
D015842:Serine Proteinase Inhibitors; D013449:Sulfonamides; C069195:sivelestat; D019272:Leukocyte Elastase; D005998:Glycine