title: Clinical evaluation of sivelestat for acute lung injury/acute respiratory distress syndrome following surgery for abdominal sepsis.
abstract: BACKGROUND
  The efficacy of sivelestat in the treatment of acute lung injury/acute respiratory distress syndrome (ALI/ARDS) has not been established. In part, this is due to the wide variety of factors involved in the etiology of ALI/ARDS. In this study, we examined the efficacy of sivelestat in patients with ALI/ARDS associated with abdominal sepsis.
  
  
  METHODS
  The subjects were 49 patients with ALI/ARDS after surgery for abdominal sepsis. The efficacy of sivelestat was retrospectively assessed in two treatment groups, ie, a sivelestat group (n = 34) and a non-sivelestat group (n = 15).
  
  
  RESULTS
  The sivelestat group showed significant improvements in oxygenation, thrombocytopenia, and multiple organ dysfunction score. The number of ventilator days (6.6 ± 6.1 versus 11.1 ± 8.4 days; P = 0.034) and length of stay in the intensive care unit (8.5 ± 6.2 versus 13.3 ± 9.5 days; P = 0.036) were significantly lower in the sivelestat group. The hospital mortality rate decreased by half in the sivelestat group, but was not significantly different between the two groups.
  
  
  CONCLUSIONS
  Administration of sivelestat to patients with ALI/ARDS following surgery for abdominal sepsis resulted in early improvements of oxygenation and multiple organ dysfunction score, early ventilator weaning, and early discharge from the intensive care unit.
authors.affiliation: Department of Anesthesiology, Nippon Medical School, Tokyo, Japan. tsubo-yossy@nms.ac.jp
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Tsuboko
authors.forename: Shinhiro
authors.initials: S
authors.lastname: Takeda
authors.forename: Seiji
authors.initials: S
authors.lastname: Mii
authors.forename: Keiko
authors.initials: K
authors.lastname: Nakazato
authors.forename: Keiji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Eiji
authors.initials: E
authors.lastname: Uchida
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Sakamoto
mesh_terms: D000005:Abdomen / Q000601:surgery*; D055371:Acute Lung Injury / Q000188:drug therapy*; D000368:Aged; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy*; D053491:Proteinase Inhibitory Proteins, Secretory / Q000627:therapeutic use*; D012128:Respiratory Distress Syndrome / Q000188:drug therapy*; D018805:Sepsis / Q000601:surgery*; D013449:Sulfonamides / Q000627:therapeutic use*; D015300:Ventilator Weaning
chemical_list: D053491:Proteinase Inhibitory Proteins, Secretory; D013449:Sulfonamides; C069195:sivelestat; D005998:Glycine
keywords: abdominal sepsis; acute lung injury; acute respiratory distress syndrome; sivelestat