ORIGINAL ARTICLES   

Chirurgia 2006 October;19(5):337-40

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: English

Administration of sivelestat after acute aortic dissection surgery

Fujii H. ¹, Kaneda H. ², Fujiwara H. I. ¹

¹ Department of Emergency and Critical Care Medicine Kansai Medical University, Osaka, Japan 2 Department of Thoracic and Cardiovascular Surgery Kansai Medical University, Osaka, Japan

Aim. The postoperative ventilation time and length of intensive care unit stay after acute aortic dissection surgery are tend to prolonged. Respiratory failure caused by systemic inflammatory response syndrome after acute aortic dissection surgery is frequent and fatal complication. In this study, benefit of using sivelestat after acute aortic dissection surgery was investigated.
Methods. This study was based on the retrospectively reviewed data concerning patients who underwent acute aortic dissection surgery at Kansai Medical University. The postoperative clinical course was compared between patients who used sivelestat (Group A) and those who did not use sivelestat (Group B). Group A was consisted of 18 patients. Group B was consisted of 22 patients.
Results. In group B, PaO2/FiO2 ratio 12 hours after surgery significantly exacerbated compared with that of immediate after surgery. In group A, both PaO2/FiO2 ratios 6 and 12 hours after surgery did not decrease compared with that of immediate after surgery. There was no significance in PaO2/FiO2 ratio immediate after surgery between group A and B. However, PaO2/FiO2 ratios 6 and 12 hours after surgery of group A significantly improved in comparison with those of group B. The postoperative intubation time and length of postoperative intensive care unit stay were significantly shortened in group A. Multivariate Cox analysis showed that administration of sivelestat was independent factor for improvement of respiratory function after acute aortic dissection surgery.
Conclusion. Sivelastat has potential to prevent systemic inflammatory response syndrome and lung dysfunction after acute aortic dissection surgery.