Clinical effects of a neutrophil elastase inhibitor, sivelestat, in patients with acute respiratory distress syndrome

J Anesth. 2006;20(1):6-10. doi: 10.1007/s00540-005-0362-9.

Abstract

Purpose: We assessed the effects of a neutrophil elastase inhibitor, sivelestat, on respiratory and organ functions as well as on the mortality of patients with acute respiratory distress syndrome (ARDS) associated with systemic inflammatory response syndrome (SIRS).

Methods: We retrospectively divided 25 patients who fulfilled the diagnostic criteria for SIRS and ARDS into two groups. One group (S group, n = 12) received a continuous infusion of sivelestat (0.2 mg.kg(-1).h(-1)), and the other did not (C group, n = 13).

Results: Between days 1 and 10, the Pa(O2)/FI(O2) ratio in the S group significantly improved from 119.1 +/- 51.1 to 214.4 +/- 88.2 mmHg (P < 0.05). Furthermore, the S group spent significantly fewer days on a ventilator than the C group (16.7 +/- 5.8 vs 26.6 +/- 14.3 days; P < 0.05). The length of the intensive care unit stay was also significantly shorter for the S group than for the C group (18.7 +/- 4.9 vs 27.5 +/- 13.5 days; P < 0.05). However, the mortality rate at 29 days did not statistically differ between the two groups.

Conclusion: Our results suggested that sivelestat has a beneficial effect only on the pulmonary function of ARDS patients with SIRS.

MeSH terms

  • Aged
  • Female
  • Glycine / analogs & derivatives*
  • Glycine / therapeutic use
  • Humans
  • Leukocyte Elastase / antagonists & inhibitors*
  • Male
  • Middle Aged
  • Respiratory Distress Syndrome / drug therapy*
  • Respiratory Distress Syndrome / mortality
  • Retrospective Studies
  • Serine Proteinase Inhibitors / therapeutic use*
  • Sulfonamides / therapeutic use*
  • Systemic Inflammatory Response Syndrome / drug therapy*
  • Systemic Inflammatory Response Syndrome / mortality

Substances

  • Serine Proteinase Inhibitors
  • Sulfonamides
  • sivelestat
  • Leukocyte Elastase
  • Glycine