The Effect of Sivelestat Sodium Hydrate on Severe Respiratory Failure after Thoracic Aortic Surgery with Deep Hypothermia

Autor: Hiroyuki Maeta, Shigeto Miyasaka, Kengo Nishimura, Keisuke Morimoto, Iwao Taniguchi
Rok vydání: 2011
Předmět:
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Serine Proteinase Inhibitors
Time Factors
medicine.medical_treatment
Glycine
Aorta
Thoracic
Lung injury
Severity of Illness Index
Pulmonary function testing
law.invention
Japan
Hypothermia
Induced
law
medicine.artery
medicine
Humans
Infusions
Parenteral
Hospital Mortality
Lung
Aged
Aged
80 and over
Mechanical ventilation
Sulfonamides
Aorta
Chi-Square Distribution
business.industry
Gastroenterology
General Medicine
Length of Stay
Hypothermia
Respiration
Artificial
Intensive care unit
Surgery
Intensive Care Units
Treatment Outcome
Respiratory failure
Cardiothoracic surgery
Anesthesia
Female
medicine.symptom
Leukocyte Elastase
Respiratory Insufficiency
Cardiology and Cardiovascular Medicine
business
Vascular Surgical Procedures
Ventilator Weaning
Zdroj: Annals of Thoracic and Cardiovascular Surgery. 17:369-375
ISSN: 2186-1005
1341-1098
DOI: 10.5761/atcs.oa.10.01555
Popis: Patients who undergo thoracic aortic surgery with deep hypothermia frequently have postoperative respiratory failure as a complication. Severe lung injury in these patients results in a fatal outcome. A specific neutrophil elastase inhibitor, sivelestat sodium hydrate, is an innovative therapeutic drug for acute lung injury. We evaluated the protective effects of sivelestat sodium hydrate on severe lung injury after thoracic aortic surgery with deep hypothermia. From January 2002 to July 2007, 71 consecutive patients underwent thoracic aortic surgery with deep hypothermia. Of these patients, 22 had postoperative respiratory failure with PaO₂/FiO₂ ratios of less than 150. They were randomly assigned to one of two groups. The first group (Group S, n = 10) was administered sivelestat sodium hydrate continuously at 0.2 mg/kg/h until weaning from mechanical ventilation; the second group (Group C, n = 12) was not administered sivelestat sodium hydrate. The groups were comparable with respect to clinical data. There were no significant differences between the two groups in age, operation duration, total cardiopulmonary bypass time, circulatory ischemia time, cardiac arrest time, intraoperative blood loss, and total transfusion volume. The improvement of pulmonary function was observed in the both groups, but more marked in Group S by statistical analysis using analysis of variance for repeated measurements. Especially, in the early phase, pulmonary function improvement was more marked in Group S. The duration of mechanical ventilation, the length of stay in the intensive care unit, and the length of hospital stay were shorter in Group S, but not significantly. Sivelestat sodium hydrate is a specific neutrophil elastase inhibitor that improves pulmonary function in patients with severe postoperative respiratory failure following thoracic aortic surgery with deep hypothermia. The drug may shorten the duration of postoperative ventilation, intensive care unit stay, and hospital stay.
Databáze: OpenAIRE
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