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Korean J Crit Care Med > Volume 24(3); 2009 > Article
Korean Journal of Critical Care Medicine 2009;24(3): 124-128. doi: https://doi.org/10.4266/kjccm.2009.24.3.124
폐암 환자의 폐절제술 후 발생한 급성 폐손상에서 호중구 Elastase 억제제 효과에 대한 예비연구
성균관대학교 의과대학 삼성서울병원 호흡기내과, *한림대학교 의과대학 성심병원 호흡기내과, †부산대학교 양산병원 응급의학과, ‡성균관대학교 의과대학 삼성서울병원 흉부외과
Effect of the Neutrophil Elastase Inhibitor on Acute Lung Injury after Pulmonary Resection for Lung Cancer: A Preliminary Study
So Young Park, Sunghoon Park, Kyeongman Jeon, So Yeon Lim, Maeng Real Park, Sueah Kim, Jae Uk Song, Jhin Gook Kim, O Jung Kwon, Gee Young Suh
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. suhgy@skku.edu
2Division of Pulmonary and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
3Department of Emergency Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
4Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
BACKGROUND: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are the leading causes of death after lungresection. Neutrophil elastase is thought to be an important mediator in the pathogenesis of ALI. Sivelestat is a new neutrophil elastase inhibitor which may improve the outcome in patients with ALI/ARDS after lung resection. The objective of this study was to determine whether or not sivelestat can reduce mortality in patients with ALI after pulmonary resection for lung cancer. METHODS: This study was a retrospective case-control study of twenty three patients who developed ALI/ARDS within seven days of lung resection for lung cancer. The control group (n = 12) received standard care, while the sivelestat group (n = 11) received a continuous infusion of sivelestat (0.2 mg/kg/hr) for seven days in addition to standard care. RESULTS: There was no significant difference in the baseline characteristics between the control and sivelestat groups, except for heart rate. Six of twelve patients (50%) in the control group survived, while seven of twelve patients (64%) survived in the sivelestat group (p = 0.34). There was also no significant difference between the two groups in the progression to ARDS. In the sivelelestat group, survivors had lower APACHE II and SOFA scores than the patients in the control group. CONCLUSIONS: There was no additional effect of a neutrophil elastase inhibitor in the treatment of ALI after pulmonary resection for lung cancer.
Key Words: acute lung injury; lung cancer; lung resection; neutrophil elastase inhibitor
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