Effects of Sivelestat Sodium Hydrate for Severe Acute Pancreatitis Complicated with Acute Lung Injury/Acute Respiratory Distress Syndrome
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We examined the effects of sivelestat sodium hydrate on the acute lung injury/acute respiratory distress syndrome (ALI/ARDS) caused by severe acute pancreatitis. Thirty-five patients with severe acute pancreatitis complicated by ALI/ARDS, on admission, and needing mechanical ventilation control were included to the study. These patients were divided into the following two groups, sivelestat sodium hydrate (Group E, n=19) and non sivelestat sodium hydrate (Group NE, n=16). We considered the admission day to be day 0. We measured the following parameters for 10 days: total fluid volum e, urine volume, Ministry of Health, Labour and Welfare severity score (severity score), SOFA score, PaO2/FIO2 ratio (P/F), white blood cell count, CRP, PMN-E, interleukin-6 (IL-6), Ventilator Free Days (VFD) and, ICU stay, infection rates. These values did not differ between the two groups: age, cause, period from acute onset to mechanical ventilation control, treatment method, total fluid volume, urine volume, and severity and SOFA scores on admission. The severity scores were significantly lower in Group E than in Group NE on days 7 and 9 (p<0.05). The SOFA scores of Group E were also significantly decreased as compared to those in Group NE on days 5, 7, and 9 (p<0.05, p<0.01). The P/F ratios were significantly higher in Group E than in Group NE on days 5, 7, and 9 (p<0.05, p<0.01). The white blood cell count and the CRP level on days 7 and 9, were significantly lower in Group E than in Group NE. The IL-6 level on day 9 and the PMN-E level on days 7 and 9 were also significantly lower in Group E than in Group NE (p<0.05). Furthermore, VFD was significantly longer in Group E than in Group NE (18.1 days vs 14.2 days; p<0.01). ICU stays were also significantly shorter in Group E than in Group NE (10.3 days vs 14.4 days; p<0.01). No significant differences in infection rates were seen between the two groups. Sivelestat sodium hydrate appears to be effective for the treatment of ALI/ARDS caused by severe acute pancreatitis.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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