[Two cases of severe sepsis successfully treated with activated protein C]

A 64-year-old man and a 52-year-old woman in shock with multiple organ failure and worsening of sepsis related organ failure assessment SOFA scores in the early days of care were treated with recombinant human activated protein C (rhAPC). In the woman sepsis was associated with reversible heart failure, with decreased ejection fraction, biventricular dilatation, and a sharp increase of troponin I, observations that have been linked to a higher rate of multiorgan failure and higher mortality. The man began to improve after 24 hours and the woman after 48 hours of rhAPC treatment, with both continuing to improve after withdrawal of treatment. Severe sepsis remains a therapeutic challenge. Among the many treatments based on the physiopathology of the disease, so far only rhAPC seems to improve outcome and reduce mortality.