[Prophylactic effects of neutrophil elastase inhibitor for patients undergoing surgery for thoracic aortic aneurysm:...

Systemic inflammatory response syndrome (SIRS) can occur after cardiac surgery under cardiopulmonary bypass (CPB), especially thoracic aortic surgery. Several reports have suggested that the earlier neutrophil elastase inhibitor (NEI) is used, the more dramatically the acute lung injury (ALI) following SIRS can be improved. We therefore examined whether prophylactic administration of NEI is effective in treating ALI following SIRS.

In a retrospective study, 24 patients were divided into a control group and a NEI group, for whom infusion of NEI 0.2 mg x kg(-1) x hr(-1) was started prior to initiation of CPB. We compared PaO2/FIO2 (P/F) ratio, intubation time, ICU stay, and numbers of intubated patients and patients admitted to the ICU between the two groups. We also examined laboratory findings for the two groups related to systemic inflammation and organ function.

In the NEI group, P/F ratio tended not to be exacerbated postoperatively, which might have been responsible in part for the finding that intubation time and ICU stay were significantly shorter and ratios of intubated patients and those staying in the ICU were significantly lower in the NEI group. Laboratory findings in the two groups fluctuated similarly.

Prophylactic administration of NEI appears to be useful for achieving early extubation and discharge from the ICU of patients undergoing thoracic aortic surgery.