• T Niino, M Hata, A Sezai, I Yoshitake, S Unosawa, K Fujita, K Shimura, S Osaka, and K Minami.
• Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan. tenino@med.nihon-u.ac.jp
• Thorac Cardiovasc Surg. 2010 Apr 1; 58 (3): 164-8.

BackgroundSurgery for type A acute aortic dissection (AAD) is associated with a high mortality and incidence of postoperative complications, including acute respiratory failure and coagulopathy. Aim of the study was to investigate the effects of sivelestat on pulmonary function and coagulopathy in patients undergoing surgery for AAD.MethodsSixty patients undergoing emergency ascending replacement for AAD were divided into two groups. Group I was administered sivelestat intravenously from the beginning of surgery until extubation. Group II was not treated with sivelestat. The platelet count, antithrombin III (AT III) level, leukocyte count, C-reactive protein (CRP) level, prothrombin time (PT), activated partial thrombin time (APTT), and prothrombin time-international normalized ratio (PT-INR) were measured.ResultsThe postoperative decrease of AT III and the platelet count on admission to the intensive care unit (ICU) and 3 hours later were significantly less in group I. The leukocyte count and the values of CRP, PT, APTT, and PT-INR did not differ significantly between the groups. The duration of mechanical ventilation after surgery tended to be shorter in group I.ConclusionsSivelestat significantly reduced the postoperative decreases in AT III and platelet count in patients undergoing emergency surgery for AAD.Georg Thieme Verlag KG Stuttgart New York.

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