Sivelestat treatment for acute respiratory distress syndrome in an infant.

Resuscitation and acute cerebral damage after cardiopulmonary arrest often induce a systemic inflammatory response and subsequently cause multiple organ failure, including acute lung injury (ALI). Sivelestat has been reported to be effective for ALI associated with systemic inflammatory response syndrome (SIRS), but the effectiveness and safety of the drug for infants has not been confirmed. We report a 33-day-old infant who developed acute respiratory distress syndrome (ARDS) following hypoxic encephalopathy immediately after successful resuscitation from cardiopulmonary arrest. Sivelestat was administered continuously for 7 days with no adverse reactions, and consolidations on a chest radiograph were diminished and impaired oxygenation was markedly alleviated. Our experience suggests that intravenous sivelestat offers a new therapeutic strategy for infantile ARDS/ALI, but further investigation of the indication, administration period, and dosage is required.