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Sivelestat (Selective Neutrophil Elastase Inhibitor) Improves the Mortality Rate of Sepsis Associated With Both Acute Respiratory Distress Syndrome and Disseminated Intravascular Coagulation Patients

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Title: Sivelestat (Selective Neutrophil Elastase Inhibitor) Improves the Mortality Rate of Sepsis Associated With Both Acute Respiratory Distress Syndrome and Disseminated Intravascular Coagulation Patients
Authors: Hayakawa, Mineji Browse this author
Katabami, Kenichi Browse this author
Wada, Takeshi Browse this author
Sugano, Masahiro Browse this author
Hoshino, Hirokatsu Browse this author
Sawamura, Atsushi Browse this author
Gando, Satoshi Browse this author
Keywords: Acute lung injury
Critically ill patients
Protease
Leukocyte
Endothelial cell
Issue Date: Jan-2010
Publisher: Lippincott Williams & Wilkins
Journal Title: Shock
Volume: 33
Issue: 1
Start Page: 14
End Page: 18
Publisher DOI: 10.1097/SHK.0b013e3181aa95c4
PMID: 19487982
Abstract: Introduction: 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. Methods: A retrospective data analysis of septic patients associated with ARDS and DIC was conducted to investigate the effects of sivelestat. Observational period was 5days after admission to ICU. Results: 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 de administered sivelestat on the admission to ICU. The lung injury scores and Pa_[O2]/Fi_[O2] ratio of the sivelestat group were significantly more severe than those of the control group from day 1 to day 4. On day 5, the lung injury score and Pa_[O2]/Fi_[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, 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. Conclusions: 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.
Rights: This is a non-final version of an article published in final form in Shock:Jan. 2010, 33(1), pp.14-18.
Relation: http://www.shockjournal.org/pt/re/shock/
Type: article (author version)
URI: http://hdl.handle.net/2115/44581
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 早川 峰司

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