Document Detail


The effects of a neutrophil elastase inhibitor on the postoperative respiratory failure of acute aortic dissection.
MedLine Citation:
PMID:  16967377     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
T Furusawa; K Tsukioka; D Fukui; M Sakaguchi; T Seto; T Terasaki; Y Wada; J Amano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  54     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-12     Completed Date:  2007-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  404-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, Division of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aneurysm, Dissecting / surgery*
Aortic Aneurysm / surgery*
Cardiopulmonary Bypass / adverse effects
Female
Glycine / analogs & derivatives*,  therapeutic use
Humans
Male
Postoperative Care
Proteinase Inhibitory Proteins, Secretory / therapeutic use*
Respiratory Insufficiency / prevention & control*
Retrospective Studies
Serine Proteinase Inhibitors / therapeutic use*
Sulfonamides / therapeutic use*
Chemical
Reg. No./Substance:
0/Proteinase Inhibitory Proteins, Secretory; 0/Serine Proteinase Inhibitors; 0/Sulfonamides; 127373-66-4/ONO 5046; 56-40-6/Glycine

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