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[Severe sepsis treated with activated protein C].
Sten Frøyshov1, Dag Jacobsen, Lars Bjertnaes
1Akuttmedisinsk avdeling, Medisinsk divisjon, Ullevål universitetssykehus, 0407 Oslo. stfr@uus.no
Summary
Recombinant human activated protein C (rhAPC) effectively reduced mortality in severe sepsis patients. This treatment is manageable in intensive care units for patients with multiple organ failure.
Area of Science:
- Critical Care Medicine
- Pharmacology
- Biochemistry
Background:
- Severe sepsis is a leading cause of death in critically ill patients.
- Recombinant human activated protein C (rhAPC) possesses anticoagulant, anti-inflammatory, and profibrinolytic properties.
- rhAPC has demonstrated efficacy in reducing severe sepsis mortality.
Purpose of the Study:
- To evaluate the safety and feasibility of rhAPC treatment in severe sepsis patients.
- To assess the impact of rhAPC on mortality in a real-world clinical setting.
Main Methods:
- An open-labeled, multi-center phase IIIb study was conducted.
- 28 severe sepsis patients received rhAPC infusion at 24 microg/kg/h for 96 hours.
- Treatment protocols adhered to the study guidelines.
Main Results:
- A 21% mortality rate (6 out of 28 patients) was observed by day 28.
- One death was possibly attributed to rhAPC.
- rhAPC was temporarily discontinued in three patients due to surgery or bleeding, with minimal interference in other procedures.
Conclusions:
- rhAPC treatment is easily administered in an intensive care unit setting.
- Severe sepsis patients with two or more failing organs are candidates for rhAPC therapy.
- The study supports the clinical utility of rhAPC in managing severe sepsis.