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[Activated proteine C].

P Montravers¹, H Quintard, P Piednoir

¹Département d'anesthésie-réanimation, CHU Bichat-Claude-Bernard, Paris, France. philippe.montravers@bch.aphp.fr

Annales Francaises D'Anesthesie Et De Reanimation

|January 3, 2006

Summary

Recombinant human activated protein C (APC) significantly decreased mortality in severe sepsis patients. This sepsis treatment, recommended by guidelines, targets inflammation and coagulation, offering a potential life-saving intervention.

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Area of Science:

Critical Care Medicine
Pharmacology
Biochemistry

Context:

Severe sepsis is a life-threatening condition characterized by dysregulated inflammation and coagulopathy.
The activated protein C (APC) pathway plays a crucial role in regulating thrombosis and inflammation during sepsis.
Existing guidelines recommend APC for severe sepsis with a Grade B level of evidence.

Purpose:

To evaluate the efficacy of recombinant human activated protein C (APC) in reducing mortality in patients with severe sepsis.
To assess APC's ability to inhibit coagulopathy and inflammatory responses associated with sepsis.
To analyze data from the PROWESS and ENHANCE trials regarding APC's impact on sepsis outcomes.

Summary:

The PROWESS trial demonstrated a significant reduction in mortality among severe sepsis patients treated with APC (24 microg/kg/h for 96 hours).
Further analyses and the ENHANCE trial corroborated these findings, confirming APC's trend towards improved survival.
APC administration targets key pathophysiological mechanisms in sepsis, including thrombin formation and endothelial cell apoptosis.

Impact:

APC represents a potential pharmacological intervention for severe sepsis, with evidence supporting its efficacy in reducing mortality.
The study highlights the established role of APC in managing sepsis-related coagulopathy and inflammation.
Further research is needed to address optimal drug usage and its integration with other sepsis therapies.

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