ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1618914
Effect of Sivelestat sodium on the incidence of ventilator -associated pneumonia in patients with sepsis and ARDS
Provisionally accepted
- 1Fuyang Second People's Hospital, Fuyang, China
- 2Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
- 3Bengbu Medical College, Bengbu, Anhui Province, China
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Objective To evaluate the efficacy of sivelestat sodium in reducing ventilator-associated pneumonia (VAP) in patients with sepsis and Acute respiratory distress syndrome (ARDS). Methods A retrospective analysis was performed on the clinical data of 187 adult patients with sepsis combined with ARDS admitted to the ICU of Fuyang Second People's Hospital from January 1, 2022 to December 1, 2024. Among these patients, 60 received sivelestat sodium as part of their treatment, while 127 did not. The treatment efficacy indices were (PaO2/ FiO2, PCT, CRP, and IL-6 levels , and VAP, bacteremia, time to first mechanical ventilation, CRRT, length of stay in ICU, length of stay, and 28-day mortality. Results There were no significant differences in age, sex, comorbidities, use of hormones, use of vasoactive drugs, APACHEⅡscore, or SOFA score between the two groups before treatment. Compared with patients who did not receive sivelestat sodium, those treated with sivelestat sodium had significantly lower incidences of VAP (χ2 = 6.910, P = 0.009) and bacteremia (χ2 = 5.372, P = 0.023), as well as shorter times to first mechanical ventilation (t = -2.071, P = 0.041) and ICU stays (t = -2.085, P = 0.039). At 28 days, the fatality rate in the sivelestat group was 33.33%, and that in the control group was 34.65%, although this slight reduction was not significant (χ2 = 0.031, P = 1.000). There was also no significant difference in the length of stay between the two groups (t = -0.609, P = 0.054). Log-Rank test analysis revealed that the time without VAP in the sivelestat group was significantly longer than that in the control group (χ2 = 7.600, P = 0.006). After adjusting for APACHE Ⅱscore and age, COX proportional risk model analysis revealed that the 28-day survival risk for VAP with sivelestat sodium was 34.67% higher than that in the control group (Z = -2.537, P = 0.011). Conclusion Sivelestat sodium therapy was associated with a reduced incidence of VAP and a shorter ICU stay in patients with ARDS. However, there was no significant benefit on 28-day survival or total hospital stay.
Keywords: No. 678, Furong Road, Economic and Technological Development Zone, Hefei City, Sivelestat sodium, ARDS, mechanical ventilation, Ventilator -associated pneumonia, Sepsis, 28-day mor tality
Received: 27 May 2025; Accepted: 15 Jul 2025.
Copyright: © 2025 Zhang, Li, Lei, Wang, Sun and Shan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xingcheng Zhang, Fuyang Second People's Hospital, Fuyang, China
Nan-bing Shan, Fuyang Second People's Hospital, Fuyang, China
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