Sivelestat (Selective Neutrophil Elastase Inhibitor) Improves the Mortality Rate of Sepsis Associated With Both Acute Respiratory Distress Syndrome and Disseminated Intravascular Coagulation Patients

• Hayakawa, Mineji

• Katabami, Kenichi

• Wada, Takeshi

• Sugano, Masahiro

• Hoshino, Hirokatsu

• Sawamura, Atsushi

• Gando, Satoshi

抄録

Introduction: Neutrophil elastase plays an important role in the development of acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC) in sepsis. Sivelestat is a selective neutrophil elastase inhibitor. It is possible that sivelestat improves the outcome of septic patients associated with ARDS and DIC. Methods: A retrospective data analysis of septic patients associated with ARDS and DIC was conducted to investigate the effects of sivelestat. Observational period was 5days after admission to ICU. Results: The study included 167 septic patients associated with ARDS and DIC. Control group included 133 patients without sivelestat and sivelestat group included 34 patients started to de administered sivelestat on the admission to ICU. The lung injury scores and Pa_[O2]/Fi_[O2] ratio of the sivelestat group were significantly more severe than those of the control group from day 1 to day 4. On day 5, the lung injury score and Pa_[O2]/Fi_[O2] ratio of the sivelestat group improved to the same levels of those of the control group. The DIC score of sivelestat group improved on day 3 in comparison to day 1, those of control group remained unchanged until day 4. The length of ICU stay of the sivelestat group was significantly shorter than that of the control group. A stepwise multiple logistic-regression analysis showed the sivelestat administration to be an independent predictor of survival of the septic patients associated with both ARDS and DIC. Conclusions: The length of ICU stay of the sivelestat group was significantly shorter than that of the control group. In addition, sivelestat administration was found to be an independent predictor of survival of those patients.

収録刊行物

• Shock

  Shock 33 (1), 14-18, 2010-01

  Lippincott Williams & Wilkins

キーワード

• Acute lung injury
• Critically ill patients
• Protease
• Leukocyte
• Endothelial cell

詳細情報

• CRID: 1050845763931079808
• NII論文ID: 120002693627
• HANDLE: 2115/44581
• ISSN: 10732322
• 本文言語コード: en
• 資料種別: journal article
• データソース種別:
  • IRDB
  • CiNii Articles