title: The use of neutrophil elastase inhibitor in the treatment of acute lung injury after pneumonectomy.
abstract: BACKGROUND
  The prognosis of acute lung injury (ALI) after pneumonectomy is poor, with reported mortality rates of 30-100%. Neutrophil elastase inhibitor (NEI) is known to prevent lung injury caused by neutrophil elastase and improve lung function in ALI. We evaluated the effect of NEI on ALI after pneumonectomy.
  
  
  METHODS
  We analyzed nine patients who required ventilator care due to ALI after pneumonectomy. Five of these patients underwent conventional ventilator care (group I), and four patients underwent ventilator care and were administrated NEI (group II). We retrospectively analyzed the lung injury score (LIS) for 10 days after intubation.
  
  
  RESULTS
  The LIS before intubation satisfied the diagnostic criteria of ALI or acute respiratory distress syndrome (ARDS) in all patients. After intubation, the LIS improved in both groups. But, as times went on, the mean value of the LIS in group II was lower compared to group I. In group I, only one patient underwent extubation. In group II, extubation was possible in three patients. Mortality rates were 80% in group I and 25% in group II.
  
  
  CONCLUSIONS
  We conclude that NEI may improve the lung function, shorten the duration of mechanical ventilation, and reduce mortality in patients with ALI after pneumonectomy.
authors.forename: Sang Kwon
authors.initials: SK
authors.lastname: Lee
authors.forename: Bong Soo
authors.initials: BS
authors.lastname: Son
authors.forename: Jung Joo
authors.initials: JJ
authors.lastname: Hwang
authors.forename: Kil Dong
authors.initials: KD
authors.lastname: Kim
authors.forename: Do Hyung
authors.initials: DH
authors.lastname: Kim
mesh_terms: D055371:Acute Lung Injury / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005998:Glycine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D053491:Proteinase Inhibitory Proteins, Secretory / Q000627:therapeutic use*; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000188:drug therapy / Q000209:etiology / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D053491:Proteinase Inhibitory Proteins, Secretory; D013449:Sulfonamides; C069195:sivelestat; D005998:Glycine