title: Sivelestat treatment for acute respiratory distress syndrome in an infant.
abstract: Resuscitation and acute cerebral damage after cardiopulmonary arrest often induce a systemic inflammatory response and subsequently cause multiple organ failure, including acute lung injury (ALI). Sivelestat has been reported to be effective for ALI associated with systemic inflammatory response syndrome (SIRS), but the effectiveness and safety of the drug for infants has not been confirmed. We report a 33-day-old infant who developed acute respiratory distress syndrome (ARDS) following hypoxic encephalopathy immediately after successful resuscitation from cardiopulmonary arrest. Sivelestat was administered continuously for 7 days with no adverse reactions, and consolidations on a chest radiograph were diminished and impaired oxygenation was markedly alleviated. Our experience suggests that intravenous sivelestat offers a new therapeutic strategy for infantile ARDS/ALI, but further investigation of the indication, administration period, and dosage is required.
authors.affiliation: Department of Brain and Nerve Science and Department of Anesthesiology, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.
authors.forename: Shigekiyo
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Seigou
authors.initials: S
authors.lastname: Hidaka
authors.forename: Koji
authors.initials: K
authors.lastname: Goto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Chihiro
authors.initials: C
authors.lastname: Shingu
authors.forename: Hideo
authors.initials: H
authors.lastname: Iwasaka
authors.forename: Takayuki
authors.initials: T
authors.lastname: Noguchi
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000378:metabolism; D016887:Cardiopulmonary Resuscitation; D005998:Glycine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007958:Leukocyte Count; D019272:Leukocyte Elastase / Q000037:antagonists & inhibitors*; D008297:Male; D010100:Oxygen / Q000097:blood; D011175:Positive-Pressure Respiration; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011859:Radiography; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013449:Sulfonamides / Q000627:therapeutic use*
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D047428:Protein Kinase Inhibitors; D013449:Sulfonamides; D002097:C-Reactive Protein; C069195:sivelestat; D019272:Leukocyte Elastase; D010100:Oxygen; D005998:Glycine