Improvement of Pulmonary Insufficiency After Aortic Dissection With Sivelestat Sodium
Status:
Not yet recruiting
Trial end date:
2024-12-31
Target enrollment:
Participant gender:
Summary
Aortic dissection (AD) is one of the most dangerous cardiovascular emergencies, with rapid
onset, rapid progression, high fatality rate, and a variety of life-threatening
complications. Acute lung injury (ALI) caused by AD is an important cause of many adverse
outcomes. Studies have confirmed that 34.9% to 53.8% of AAD patients have ALI before surgery,
and Impaired preoperative lung function may lead to worse oxygenation after AD surgery. The
pathophysiological mechanism of AD-induced ALI is complex. A variety of preoperative and
intraoperative risk factors can induce or aggravate ALI, such as ischemia-reperfusion injury,
deep hypothermic circulatory arrest, and inflammatory reactions. At present, the clinical use
of improved surgery, cardiopulmonary bypass perfusion, early anti-inflammatory treatment, and
protective lung ventilation can reduce and improve perioperative ALI to a certain extent, but
it is still not ideal. In recent years, inhibition of neutrophil activation and aggregation,
and reduction of neutrophil elastase activity as targets for the treatment of inflammatory
injury have also become an important clinical treatment measure, in order to further reduce
the body's inflammatory response to improve and alleviate ALI. Sivelestat sodium, as a
neutrophil elastase inhibitor, is the only approved therapeutic drug for ALI/ acute
respiratory distress syndrome (ARDS) in the world. It is precisely by reducing the
inflammatory infiltration of neutrophils and inhibiting neutrophil elastase activity, thereby
exerting a certain protective effect on the lungs. The study takes patients with AD surgery
as the research object. On the basis of not terminating and changing the original treatment
plans, sivelestat sodium was added in the perioperative period to observe the incidence, and
severity of ALI/ARDS in the perioperative period. It aims to explore the efficacy and safety
of sivelestat sodium in the treatment of pulmonary insufficiency after AD arch surgery under
hypothermic circulatory arrest.
Phase:
N/A
Details
Lead Sponsor:
First Affiliated Hospital Xi'an Jiaotong University