A survey of the effects of sivelestat sodium administration on patients with postoperative respiratory dysfunction.
OBJECTIVE
To clarify the clinical significance of sivelestat sodium (SIV) administration, we surveyed the status of 40 patients treated with SIV for respiratory dysfunction following surgery.


METHODS
The subjects were patients who received SIV administration due to systemic inflammatory response syndrome (SIRS) and respiratory dysfunction (PaO(2)/F(I)O(2) ratio ≤300 mmHg) after surgery at the Department of Surgery and Science, Kyushu University, and related facilities between April and December 2008.


RESULTS
The most frequent underlying condition was perforation of the digestive tract, followed by cancer of the upper digestive organs. The main causes of SIRS were surgical stress and infection. The mean P/F ratio at the initiation of SIV administration was 185.5 ± 72.0 mmHg. The ratio increased, and the number of SIRS-related factors decreased with time after SIV administration. Sivelestat sodium was administered within 24 h after the onset of respiratory dysfunction in 87.5% of the patients, and the survival rate at 28 days after the initiation of SIV administration was 90.0%.


CONCLUSIONS
Our findings suggest that multidisciplinary postoperative management, including the administration of SIV, during the early phase after the onset of respiratory dysfunction leads to improvements in respiratory function and survival.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Hiroshi
H
Saeki
Masaru
M
Morita
Noboru
N
Harada
Norifumi
N
Harimoto
Shigeyuki
S
Nagata
Mitsuhiro
M
Miyazaki
Tadashi
T
Koga
Eiji
E
Oki
Yoshihiro
Y
Kakeji
Yoshihiko
Y
Maehara
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005998:Glycine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007249:Inflammation / Q000473:pathology; D007564:Japan / Q000453:epidemiology; D008171:Lung Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000401:mortality / Q000523:psychology; D012307:Risk Factors; D015842:Serine Proteinase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D013315:Stress, Psychological; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use*; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy* / Q000209:etiology
D015842:Serine Proteinase Inhibitors; D013449:Sulfonamides; C069195:sivelestat; D005998:Glycine