2013 Volume 4 Issue 1 Pages 23-27
Sivelestat sodium hydrate (SSH), a neutrophil elastase inhibitor, is used for the treatment of acute respiratory distress syndrome. However, acute renal failure may develop as a complication, and thus continuous renal replacement therapy (CRRT) is performed for many cases, leading to concerns about loss of the drug. Therefore, we examined the membrane permeability of SSH using a simulation circuit of CRRT. In the study, we added 20 mg of SSH to bovine blood or 4.5 L of saline, and circulated the solution in the CRRT simulation circuit for 2 hours, 3 times. Sampling was performed from 3 points, the blood return and removal sites and the filtrate, in 30-minute intervals. SSH concentrations were measured using HPLC. While SSH concentrations in the bovine blood on the side of filtration circuit were low regardless of the draining, SSH concentrations in saline increased on the sides of blood return and filtration circuit along with draining. SSH is highly protein bound, and thus does not permeate the membrane when it is in blood, even after 6 hours of CRRT. Therefore, no loss of SSH would be occur with CRRT, and does not pose a clinical problem.
