[Efficacy of sivelestat for acute lung injury due to severe bacterial pneumonia with systemic inflammatory response syndrome].

Abstract

OBJECTIVE:

Neutrophil elastase is believed to play an important role in acute lung injury (ALI). Sivelestat is a small molecular weight neutrophil elastase inhibitor. Although some authors reported its efficacy in ALI, it is unclear whether sivelestat has good effects in ALI, especially in cases due to severe bacterial pneumonia. The purpose of this study is to investigate the effect of sivelestat to ALI due to severe bacterial pneumonia.

METHODS:

We performed a retrospective study of 28 patients who were admitted for severe bacterial pneumonia (pneumonia severity index; PSI class V). We investigated the patients' background, pneumonia severity score, the days from diagnosis of systemic inflammatory response syndrome (SIRS) to sivelestat administration, P/F ratio, SIRS score, and compared two groups: those who survived and those who died.

RESULTS:

There were no significant background differences between the two groups. In pneumonia severity score, chest X-ray film score was higher in the group of fatalities than in the survival group. In the survival cases, sivelestat had been administered earlier than in the cases that died. In the survival cases, improvement in P/F ratio, body temperature, heart rate, and respiratory rate were shown. The total number of SIRS scores also decreased in survival cases.

CONCLUSION:

This study suggested the possibility that early administration of sivelestat may improve the ALI survival rate in severe pneumonia.

• Authors: Shigeki Nakamura, Katsunori Yanagihara, Koichi Izumikawa, Masafumi Seki, Hiroshi Kakeya, Yoshihiro Yamamoto, Hiroshi Mukae, Takayoshi Tashiro, Shigeru Kohno
• Journal: Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society (Nihon Kokyuki Gakkai Zasshi) Vol. 46 Issue 10 Pg. 793-7 (Oct 2008) ISSN: 1343-3490 [Print] Japan
• PMID: 19044028 (Publication Type: English Abstract, Journal Article)

Chemical References

• Serine Proteinase Inhibitors
• Sulfonamides
• sivelestat
• Leukocyte Elastase
• Glycine

Topics

• Acute Lung Injury (drug therapy, etiology)
• Aged
• Aged, 80 and over
• Female
• Glycine (administration & dosage, analogs & derivatives)
• Humans
• Leukocyte Elastase (antagonists & inhibitors)
• Male
• Pneumonia, Bacterial (complications)
• Retrospective Studies
• Serine Proteinase Inhibitors (administration & dosage)
• Severity of Illness Index
• Sulfonamides (administration & dosage)
• Systemic Inflammatory Response Syndrome (complications)