This study shows that dexmedetomidine is an effective sedative drug for patients with NIV.

BackgroundThe efficacy of sivelestat in the treatment of acute lung injury/acute respiratory distress syndrome (ALI/ARDS) has not been established. In part, this is due to the wide variety of factors involved in the etiology of ALI/ARDS. In this study, we examined the efficacy of sivelestat in patients with ALI/ARDS associated with abdominal sepsis.MethodsThe subjects were 49 patients with ALI/ARDS after surgery for abdominal sepsis. The efficacy of sivelestat was retrospectively assessed in two treatment groups, ie, a sivelestat group (n = 34) and a non-sivelestat group (n = 15).ResultsThe sivelestat group showed significant improvements in oxygenation, thrombocytopenia, and multiple organ dysfunction score. The number of ventilator days (6.6 ± 6.1 versus 11.1 ± 8.4 days; P = 0.034) and length of stay in the intensive care unit (8.5 ± 6.2 versus 13.3 ± 9.5 days; P = 0.036) were significantly lower in the sivelestat group. The hospital mortality rate decreased by half in the sivelestat group, but was not significantly different between the two groups.ConclusionAdministration of sivelestat to patients with ALI/ARDS following surgery for abdominal sepsis resulted in early improvements of oxygenation and multiple organ dysfunction score, early ventilator weaning, and early discharge from the intensive care unit.

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Purpose: To assess the arterial stiffness in patients with branch retinal vein occlusion (BRVO). Methods: Brachial-ankle pulse wave velocity (PWV) and ankle-brachial index were measured in 10 patients with BRVO (mean age 67.9 ± 7.5 years) and in 18 age-matched controls (mean age 66.9 ± 6.8 years). The controls were subjects with systemic essential hypertension having no retinal lesions. Results: The PWV in the BRVO group was 1,946 ± 254 cm/s which was significantly higher than that in the control group (1,688 ± 274 cm/s; p = 0.014, Wilcoxon rank sum test). The ankle-brachial indexes were 1.16 and 1.15 in BRVO and control groups, respectively. There was no significant difference between the groups (p = 0.944). In the control group, there was a significant positive correlation between PWV and systolic blood pressure (Spearman correlation coefficient r_s = 0.385, p = 0.043), while no significant correlation was found in the BRVO group (Spearman correlation coefficient r_s = –0.188, p = 0.603). Conclusion: The arterial stiffness is increased in patients with BRVO which was thought to be due to the structural changes of the artery and not dependent on the blood pressure.