Thorac Cardiovasc Surg 2006; 54(6): 404-407
DOI: 10.1055/s-2006-924195
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

The Effects of a Neutrophil Elastase Inhibitor on the Postoperative Respiratory Failure of Acute Aortic Dissection

T. Furusawa1 , K. Tsukioka1 , D. Fukui1 , M. Sakaguchi1 , T. Seto1 , T. Terasaki1 , Y. Wada1 , J. Amano1
  • 1Department of Surgery, Division of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Japan
Further Information

Publication History

Received October 4, 2005

Publication Date:
07 September 2006 (online)

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Abstract

Background: Postoperative respiratory failure is often encountered in patients suffering from acute aortic dissection (AAD) and is believed to be influenced by release of neutrophil elastase after cardiopulmonary bypass. Sivelestat is a specific neutrophil elastase inhibitor, and this study aims to evaluate the effects of sivelestat on postoperative respiratory failure due to AAD. Methods and Results: Patients who were operated for AAD from January 2000 to April 2005 and who had less than 300 mmHg initial postoperative PaO2/FiO2 were investigated retrospectively and divided into two groups. Group 1 (n = 9) received intravenous administration of sivelestat immediately after the operation, while Group II (n = 9) received no sivelestat. There were no significant differences between Group I and II with respect to patients' characteristics or background (age, body weight, operating time, cardiopulmonary bypass time, amount of bleeding, preoperative WBC number and initial PaO2/FiO2). Though patients in Group I showed a subtle improvement in certain parameters such as PaO2/FiO2, A‐aDO2 and respiratory index (RI) over a 3-day observation period compared to those of Group II, there were no significant differences. Neither postoperative mechanical ventilation time nor ICU stay differed between Group I and II. However, Group I showed a significantly greater improvement in the ratio of RI to initial RI on the 3POD compared to that of Group II (61.6 ± 44.2 % vs. 111.9 ± 40.9 %, p = 0.02). Conclusion: Inhibiting the activity of the neutrophil elastase may attenuate the postoperative respiratory complications of patients with AAD.

References

J. Amano

Department of Surgery
Division of Cardiovascular Surgery
Shinshu University School of Medicine

3-1-1 Asahi, Matsumoto

390-8621 Japan

Phone: + 81 2 63 37 26 57

Fax: + 81 2 63 37 27 21

Email: junamano@hsp.md.shinshu-u.ac.jp