The Effects of a Neutrophil Elastase Inhibitor on the Postoperative Respiratory Failure of Acute Aortic Dissection
| Autor: | Takamitsu Terasaki, Yuko Wada, Jun Amano, Daisuke Fukui, K. Tsukioka, Tatsuichiro Seto, Takehiko Furusawa, Masayuki Sakaguchi |
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| Rok vydání: | 2006 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Serine Proteinase Inhibitors medicine.medical_treatment Glycine Proteinase Inhibitory Proteins Secretory law.invention chemistry.chemical_compound law medicine Cardiopulmonary bypass Humans Aged Retrospective Studies Postoperative Care Aortic dissection Mechanical ventilation Sulfonamides Cardiopulmonary Bypass Lung biology business.industry Sivelestat Retrospective cohort study medicine.disease Aortic Aneurysm Aortic Dissection medicine.anatomical_structure chemistry Respiratory failure Anesthesia Neutrophil elastase Acute Disease biology.protein Female Surgery Respiratory Insufficiency Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Thoracic and Cardiovascular Surgeon. 54:404-407 |
| ISSN: | 1439-1902 0171-6425 |
| Popis: | Background Postoperative respiratory failure is often encountered in patients suffering from acute aortic dissection (AAD) and is believed to be influenced by release of neutrophil elastase after cardiopulmonary bypass. Sivelestat is a specific neutrophil elastase inhibitor, and this study aims to evaluate the effects of sivelestat on postoperative respiratory failure due to AAD. Methods and results Patients who were operated for AAD from January 2000 to April 2005 and who had less than 300 mmHg initial postoperative PaO (2)/FiO (2) were investigated retrospectively and divided into two groups. Group 1 (n = 9) received intravenous administration of sivelestat immediately after the operation, while Group II (n = 9) received no sivelestat. There were no significant differences between Group I and II with respect to patients' characteristics or background (age, body weight, operating time, cardiopulmonary bypass time, amount of bleeding, preoperative WBC number and initial PaO (2)/FiO (2)). Though patients in Group I showed a subtle improvement in certain parameters such as PaO (2)/FiO (2), A-aDO (2) and respiratory index (RI) over a 3-day observation period compared to those of Group II, there were no significant differences. Neither postoperative mechanical ventilation time nor ICU stay differed between Group I and II. However, Group I showed a significantly greater improvement in the ratio of RI to initial RI on the 3POD compared to that of Group II (61.6 +/- 44.2 % vs. 111.9 +/- 40.9 %, P = 0.02). Conclusion Inhibiting the activity of the neutrophil elastase may attenuate the postoperative respiratory complications of patients with AAD. |
| Databáze: | OpenAIRE |
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