BACKGROUND/AIMS: The usefulness of a neutrophil elastase inhibitor (sivelestat) was evaluated for treating septic acute respiratory distress syndrome (ARDS) after gastrointestinal surgery. METHODOLOGY: The subjects were 36 patients with septic ARDS after gastrointestinal surgery. ARDS was defined as acute lung injury associated with systemic inflammatory response syndrome. Sivelestat was intravenously administered at a dose of 0.2 mg/kg/hr continuously for 3 days or more. The effectiveness of sivelestat was evaluated based on the lung injury score, P/F ratio, and ventilator free days (VFD). RESULTS: Marked responses were observed in 12 patients (33.3%), responses in 17 (47.2%), and no response in 7 (19.4%). In the patients with marked responses or responses (responders), the P/F ratio was significantly improved on day 3 of drug administration and at the end of administration compared with the pre-administration ratio. Comparison between the responders and non-responders showed significant differences on day 3 and at the end of drug administration. VFD significantly differed between the responders (18.8 days) and the non-responders (11.0 days). CONCLUSION: In conclusion, sivelestat may be effective against septic ARDS. The effectiveness of the drug could be determined based on improvement in oxygenation ability on day 3 of drug administration.
BACKGROUND/AIMS: The usefulness of a neutrophil elastase inhibitor (sivelestat) was evaluated for treating septic acute respiratory distress syndrome (ARDS) after gastrointestinal surgery. METHODOLOGY: The subjects were 36 patients with septic ARDS after gastrointestinal surgery. ARDS was defined as acute lung injury associated with systemic inflammatory response syndrome. Sivelestat was intravenously administered at a dose of 0.2 mg/kg/hr continuously for 3 days or more. The effectiveness of sivelestat was evaluated based on the lung injury score, P/F ratio, and ventilator free days (VFD). RESULTS: Marked responses were observed in 12 patients (33.3%), responses in 17 (47.2%), and no response in 7 (19.4%). In the patients with marked responses or responses (responders), the P/F ratio was significantly improved on day 3 of drug administration and at the end of administration compared with the pre-administration ratio. Comparison between the responders and non-responders showed significant differences on day 3 and at the end of drug administration. VFD significantly differed between the responders (18.8 days) and the non-responders (11.0 days). CONCLUSION: In conclusion, sivelestat may be effective against septic ARDS. The effectiveness of the drug could be determined based on improvement in oxygenation ability on day 3 of drug administration.