| Combined antithrombin and protein C supplementation in meningococcal purpura fulminans: a pharmacokinetic study. | |
| | |
MedLine Citation:
|
PMID: 12761614 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
PURPOSE: To document in patients with meningococcal purpura fulminans (PF), the effects of a combined supplementation with antithrombin (AT) and protein C (PC) plasma concentrates and to estimate the pharmacokinetics and dose requirements of each inhibitor. DESIGN: Retrospective study of 15 patients. SETTING. One paediatric and one adult ICU in a university hospital. INTERVENTIONS: In addition to standard intensive care, all patients received a 100 IU/kg loading dose of AT and PC concentrates, followed by a continuous infusion (AT: 100-150 IU.kg.day; PC: 100 IU.kg.day in adults, and 400 IU/kg in infants). MEASUREMENTS: Clinical data, coagulation, and fibrinolysis parameters, AT and PC activities, and free protein S (PS) levels were sequentially measured. Restitution ratio, median increment after supplementation, and half-life of clearance from plasma were calculated for the two plasma substitutes. RESULTS. At admission, all patients had a severe decrease in AT, PC, and PS levels. The supplementation regimen induced a substantial increase in AT and PC activities, peaking at H18 and H48, respectively. The supplementation procedure did not modify free PS levels. The median values of AT and PC restitution ratio, increment in plasma activity observed after 100 IU/kg concentrate, and apparent half-life of clearance from plasma were 0.85 U.ml.U.kg and 0.59 U.ml.U.kg, 23% and 21%, 16 h and 6 h, respectively. CONCLUSION: If AT and PC concentrates are to be given in fulminant meningococcemia, the doses of supplementation should be at least 150 IU/kg AT and 250 IU/kg PC as loading dose and 150 IU/kg AT and 200 IU/kg PC as daily maintenance therapy. Taking into account the individual variability in inhibitor deficiency and restitution ratio, repeated measurements of plasma levels are mandatory to obtain a patient-based adjustment of the supplementation. |
| | |
Authors:
|
François Fourrier; Francis Leclerc; Karl Aidan; Ahmed Sadik; Mercé Jourdain; Antoine Tournoys; Odile Noizet |
Related Documents
:
|
2669364 - Pharmacokinetics of the antidepressant rolipram in healthy volunteers. 20406214 - Grapefruit juice enhances the exposure to oral oxycodone. 7060314 - Clinical kinetics of 1, 4-dihydroxy-5,8-bis [(2-[(2-hydroxyethyl) amino] ethyl] amino ]... 6576394 - The pharmacokinetics of mianserin in elderly depressed patients. 19046824 - Designing targets for elective nodal irradiation in lung cancer radiotherapy: a plannin... 7336764 - The estimation of low-dose hazards by extrapolation from high doses. |
Publication Detail:
|
Type: Journal Article Date: 2003-05-22 |
Journal Detail:
|
Title: Intensive care medicine Volume: 29 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2003 Jul |
Date Detail:
|
Created Date: 2003-07-09 Completed Date: 2003-12-09 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
|
Languages: eng Pagination: 1081-7 Citation Subset: IM |
Affiliation:
|
Service de Réanimation, Polyvalente Hôpital Roger Salengro, CHRU, 59037, Lille, France. f-fourrier@chru-lille.fr |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Antithrombins
/
administration & dosage,
pharmacokinetics* France Humans Meningococcal Infections / complications, drug therapy*, metabolism Protein C / administration & dosage, pharmacokinetics* Purpura, Schoenlein-Henoch / drug therapy*, etiology, metabolism Retrospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Antithrombins; 0/Protein C |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The safety of the donor operation in living-donor liver transplantation: an analysis of 45 donors.
Next Document: A novel citrate anticoagulation regimen for continuous venovenous hemodiafiltration.