Efficacy Of Cilverestanol In The Treatment Of ARDS Associated With Sepsis

Background:Sepsis associated Acute respiratory distress syndrome(ARDS)has a high morbidity and mortality in clinic.Patients often need intensive care unit(ICU),and may require invasive mechanical ventilation support.At present,invasive positive pressure ventilation,prone ventilation and other methods have achieved good results,but there is no specific drug treatment.Based on conventional anti-infective drugs,it is the key to find a drug that can effectively reduce inflammatory response,improve lung ventilation function,improve patients’ oxygenation index,so that patients can avoid invasive treatment and improve clinical outcome.Purpose:The objective of this study was to investigate the efficacy of cilvelestat sodium in the treatment of sepsis related ARDS.By comparing the oxygenation index,inflammation index,infection index,serum KL-6 level,APACHE II score,SOFA score,ICU stay time,invasive ventilation time of patients before and after treatment,to clarify the therapeutic value of cilvelestat sodium in the treatment of sepsis related ARDS,and to provide more options for clinical treatment.Method:The patients diagnosed with sepsis related ARDS admitted to the Department of Intensive Care Medicine of China-Japan Friendship Hospital of Jilin University from December 2021 to December 2022 were selected.They were divided into two groups by random number table method.The control group was given basic treatment,and the observation group was given sivestat sodium 0.2 mg/kg/h on the basis of basic treatment from the day of diagnosis with continuous intravenous drip for at least 7 days.Clinically relevant indicators were recorded on the day of diagnosis and 7 days after treatment,respectively,and were recorded until patients finally improved and were transferred out of ICU or died clinically.Results:This study included 32 subjects in the control group and 28 subjects in the observation group.1.By comparing the basic information of the two groups of patients:age,gender,BMI,underlying diseases,SOFA score and APACHE II score at diagnosis,there was no statistical difference in vital signs at diagnosis,indicating that the two groups of patients were comparable.2.The white blood cell count,C-reactive protein,IL-6 and IL-8of the two groups showed no statistical difference before treatment,but decreased after treatment compared with before treatment,the difference was statistically significant,and the secondary decrease was more obvious in the observation group compared with the control group.There was no statistical difference between the two groups before treatment,and the oxygenation index was higher after treatment than before treatment,and the increase was more obvious in the observation group than the control group.There was no significant difference in liver and kidney function between the two groups before and after treatment.There was no statistical difference in serum KL-6 level between the two groups before treatment,and it was lower after treatment than before treatment,and the reduction was more obvious in the observation group than the control group.3.By comparing the treatment results between the two groups,there was no statistical difference between the two groups in terms of mortality and whether patients experienced invasive ventilation,but the observation group had a shorter length of ICU stay than the treatment group,and the difference was statistically significant.Conclusion:1.Cilvelestat sodium is helpful to treat sepsis related ARDS and reduce systemic inflammatory response in patients;2.Cilvelestat sodium can improve lung injury and oxygenation index in patients with sepsis related ARDS.3.Cilvelestat sodium can improve the severity of sepsis related ARDS patients and reduce the length of ICU stay.4.Cilvelestat sodium is safe in treating sepsis related ARDS,and has no significant effect on liver and kidney function.