A survey of the effects of sivelestat sodium administration on patients with postoperative respiratory dysfunction

Surg Today. 2010 Nov;40(11):1034-9. doi: 10.1007/s00595-010-4296-y. Epub 2010 Nov 3.

Abstract

Purpose: To clarify the clinical significance of sivelestat sodium (SIV) administration, we surveyed the status of 40 patients treated with SIV for respiratory dysfunction following surgery.

Methods: The subjects were patients who received SIV administration due to systemic inflammatory response syndrome (SIRS) and respiratory dysfunction (PaO(2)/F(I)O(2) ratio ≤300 mmHg) after surgery at the Department of Surgery and Science, Kyushu University, and related facilities between April and December 2008.

Results: The most frequent underlying condition was perforation of the digestive tract, followed by cancer of the upper digestive organs. The main causes of SIRS were surgical stress and infection. The mean P/F ratio at the initiation of SIV administration was 185.5 ± 72.0 mmHg. The ratio increased, and the number of SIRS-related factors decreased with time after SIV administration. Sivelestat sodium was administered within 24 h after the onset of respiratory dysfunction in 87.5% of the patients, and the survival rate at 28 days after the initiation of SIV administration was 90.0%.

Conclusion: Our findings suggest that multidisciplinary postoperative management, including the administration of SIV, during the early phase after the onset of respiratory dysfunction leads to improvements in respiratory function and survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Glycine / administration & dosage
  • Glycine / analogs & derivatives*
  • Glycine / therapeutic use
  • Health Status
  • Health Surveys
  • Humans
  • Inflammation / pathology
  • Japan / epidemiology
  • Lung Diseases / drug therapy*
  • Male
  • Middle Aged
  • Postoperative Complications / drug therapy*
  • Postoperative Complications / mortality
  • Postoperative Complications / psychology
  • Risk Factors
  • Serine Proteinase Inhibitors / administration & dosage
  • Serine Proteinase Inhibitors / therapeutic use*
  • Stress, Psychological
  • Sulfonamides / administration & dosage
  • Sulfonamides / therapeutic use*
  • Systemic Inflammatory Response Syndrome / drug therapy*
  • Systemic Inflammatory Response Syndrome / etiology

Substances

  • Serine Proteinase Inhibitors
  • Sulfonamides
  • sivelestat
  • Glycine