Document Detail


Hemodynamic effects of recombinant human activated protein C in patients with septic shock.
MedLine Citation:
PMID:  19781904     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The aim of this study is to examine the effects of recombinant human activated protein C (rhAPC) on hemodynamic parameters in patients with septic shock. METHODS: This is a retrospective study of 2 university-hospital critical care units. Patients with septic shock with pulmonary artery catheterization or transthoracic thermodilution monitoring were studied. We matched patients with septic shock with at least 2 organ failures (18 treated with rhAPC and 18 controls) on sex, age, sequential organ failure assessment (SOFA), Acute Physiology and Chronic Health Evaluation (APACHE) II, and sepsis etiology. We recorded norepinephrine dose and hemodynamic parameters at baseline and 24, 36, and 48 hours after the real or theoretical start of rhAPC treatment. RESULTS: Mean arterial pressure remained stable in both groups. In rhAPC patients, norepinephrine requirements, initially higher than in controls, were significantly lower at 48 hours, and stroke volume at 24 and 48 hours improved (P < .05). CONCLUSION: Recombinant human activated protein C use correlated with improved hemodynamic parameters and decreased norepinephrine requirements. The retrospective nature of the study limits the strength of these findings.
Authors:
Baltasar Sanchez; Enrique Piacentini; Vittorio Pradella; Mariano Mignini; Juan Nava
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Publication Detail:
Type:  Journal Article     Date:  2009-09-24
Journal Detail:
Title:  Journal of critical care     Volume:  25     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-10     Completed Date:  2010-07-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  343-7     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier Inc. All rights reserved.
Affiliation:
Intensive Care Unit, Hospital Mútua deTerrassa, Terrassa, Spain.
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MeSH Terms
Descriptor/Qualifier:
APACHE
Case-Control Studies
Catheterization, Swan-Ganz
Female
Hemodynamics / drug effects*
Humans
Male
Middle Aged
Norepinephrine / administration & dosage
Protein C / pharmacology*,  therapeutic use
Recombinant Proteins / pharmacology*,  therapeutic use
Retrospective Studies
Shock, Septic / drug therapy,  physiopathology*
Thermodilution
Treatment Outcome
Vasodilator Agents / pharmacology*,  therapeutic use
Chemical
Reg. No./Substance:
0/Protein C; 0/Recombinant Proteins; 0/Vasodilator Agents; 51-41-2/Norepinephrine

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