Document Detail


Sivelestat (selective neutrophil elastase inhibitor) improves the mortality rate of sepsis associated with both acute respiratory distress syndrome and disseminated intravascular coagulation patients.
MedLine Citation:
PMID:  19487982     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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. A retrospective data analysis of septic patients associated with ARDS and DIC was conducted to investigate the effects of sivelestat. Observational period was 5 days after admission to intensive care unit (ICU). 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 deadministered sivelestat on the admission to ICU. The lung injury scores and Pa(O2)/Fl(O2) ratio of the sivelestat group were significantly more severe than those of the control group from days 1 to 4. On day 5, the lung injury score and Pa(O2)/Fl(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, and 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. 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.
Authors:
Mineji Hayakawa; Kenichi Katabami; Takeshi Wada; Masahiro Sugano; Hirokatsu Hoshino; Atsushi Sawamura; Satoshi Gando
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  33     ISSN:  1540-0514     ISO Abbreviation:  Shock     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-22     Completed Date:  2010-03-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  United States    
Other Details:
Languages:  eng     Pagination:  14-8     Citation Subset:  IM    
Affiliation:
Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan. mineji@dream.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Disseminated Intravascular Coagulation / drug therapy*,  etiology*
Female
Glycine / analogs & derivatives*,  therapeutic use
Humans
Male
Middle Aged
Respiratory Distress Syndrome, Adult / drug therapy*,  etiology*
Retrospective Studies
Sepsis / complications*,  drug therapy*
Serine Proteinase Inhibitors / therapeutic use
Sulfonamides / therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Serine Proteinase Inhibitors; 0/Sulfonamides; 127373-66-4/ONO 5046; 56-40-6/Glycine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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