1. The use of neutrophil elastase inhibitor in the treatment of acute lung injury after pneumonectomy
- Author
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Jung Joo Hwang, Sang Kwon Lee, Do Hyung Kim, Kil Dong Kim, and Bong Soo Son
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,ARDS ,medicine.medical_treatment ,Acute Lung Injury ,Glycine ,Proteinase Inhibitory Proteins, Secretory ,Lung injury ,Drug Administration Schedule ,Pneumonectomy ,Postoperative Complications ,medicine ,Intubation ,Humans ,Infusions, Intravenous ,Aged ,Retrospective Studies ,Mechanical ventilation ,Respiratory Distress Syndrome ,Sulfonamides ,biology ,business.industry ,General Medicine ,respiratory system ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Respiration, Artificial ,Cardiac surgery ,Surgery ,respiratory tract diseases ,Treatment Outcome ,Cardiothoracic surgery ,Neutrophil elastase ,Anesthesia ,biology.protein ,business ,Cardiology and Cardiovascular Medicine ,Research Article - Abstract
Background The prognosis of acute lung injury (ALI) after pneumonectomy is poor, with reported mortality rates of 30-100%. Neutrophil elastase inhibitor (NEI) is known to prevent lung injury caused by neutrophil elastase and improve lung function in ALI. We evaluated the effect of NEI on ALI after pneumonectomy. Methods We analyzed nine patients who required ventilator care due to ALI after pneumonectomy. Five of these patients underwent conventional ventilator care (group I), and four patients underwent ventilator care and were administrated NEI (group II). We retrospectively analyzed the lung injury score (LIS) for 10 days after intubation. Results The LIS before intubation satisfied the diagnostic criteria of ALI or acute respiratory distress syndrome (ARDS) in all patients. After intubation, the LIS improved in both groups. But, as times went on, the mean value of the LIS in group II was lower compared to group I. In group I, only one patient underwent extubation. In group II, extubation was possible in three patients. Mortality rates were 80% in group I and 25% in group II. Conclusions We conclude that NEI may improve the lung function, shorten the duration of mechanical ventilation, and reduce mortality in patients with ALI after pneumonectomy.
- Published
- 2013