| Recombinant human soluble thrombomodulin improves mortality and respiratory dysfunction in patients with severe sepsis. | |
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MedLine Citation:
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PMID: 22673239 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: : Respiratory dysfunction associated with severe sepsis is a serious condition leading to poor prognosis. Activation of coagulation is a consequence of and contributor to ongoing lung injury in severe sepsis. The purpose of this study was to examine the efficacy of recombinant human soluble thrombomodulin (rhTM), a novel anticoagulant agent, for treating patients with sepsis-induced disseminated intravascular coagulation (DIC) in terms of mortality and respiratory dysfunction. METHODS: : This study comprised 86 consecutive patients with sepsis-induced DIC who required ventilator management. The initial 45 patients were treated without rhTM (control group), and the following 41 patients were given rhTM (0.06 mg/kg/d) for 6 days (rhTM group). Patients were followed up for 90 days after study entry. Sequential Organ Failure Assessment (SOFA) score and lung injury score were recorded until 7 days after entry. RESULTS: : The baseline characteristic of severity of illness was significantly higher in the rhTM group than in the control group. Nevertheless, 90-day mortality rate in the rhTM group was significantly lower than that in the control group (37% vs. 58%, p = 0.038). There was a significant difference in the serial change of SOFA score from baseline to day 7 between the two groups (p = 0.009). Both the respiratory component of the SOFA score and the lung injury score in the rhTM group were significantly lower compared with the control group (p = 0.034 and p < 0.001, respectively). CONCLUSIONS: : rhTM may have a significant beneficial effect on mortality and respiratory dysfunction in patients with sepsis-induced DIC. LEVEL OF EVIDENCE: : III, therapeutic study. |
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Authors:
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Yoshihito Ogawa; Kazuma Yamakawa; Hiroshi Ogura; Takeyuki Kiguchi; Tomoyoshi Mohri; Yasushi Nakamori; Yasuyuki Kuwagata; Takeshi Shimazu; Toshimitsu Hamasaki; Satoshi Fujimi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The journal of trauma and acute care surgery Volume: 72 ISSN: 2163-0763 ISO Abbreviation: J Trauma Acute Care Surg Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-06-07 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101570622 Medline TA: J Trauma Acute Care Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1150-7 Citation Subset: AIM; IM |
Affiliation:
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Osaka, Japan From the Department of Emergency and Critical Care (Y.O., T.K., T.M., Y.N., S.F.), Osaka General Medical Center; Department of Traumatology and Acute Critical Medicine (Y.O., K.Y., H.O., Y.K., T.S.), Osaka University Graduate School of Medicine; and Department of Biomedical Statistics (T.H.), Osaka University Graduate School of Medicine, Osaka, Japan. |
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