Sivelestat and Incidence of Acute Respiratory Distress Syndrome After Cardiovascular Surgery

Does postoperative administration of the neutrophil elastase inhibitor sivelestat reduce the incidence of acute respiratory distress syndrome (ARDS) among patients undergoing cardiovascular surgery with cardiopulmonary bypass?In this randomized, placebo-controlled clinical trial of 424 patients, sivelestat significantly reduced the incidence of postoperative ARDS (16.8% vs 31.2%) and 90-day all-cause mortality (1.1% vs 5.2%) compared with placebo.These findings suggest that sivelestat may be an effective pharmacologic strategy for preventing ARDS and improving survival in patients undergoing cardiovascular surgery with cardiopulmonary bypass.

Corresponding Authors: Qiang Wang, MD, Cardiovascular Medical Center, Nanjing Drum Tower Hospital, Building 21, No. 99, Qunli Avenue, Economic Development Zone, Nanjing, Jiangsu, 210000, China (njuwangqiang@163.com); Jason Z. Qu, MD, Division of Cardiac Anesthesia, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Jackson 4-418, Boston, MA 02114 (jqu@mgh.harvard.edu).

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