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Báo cáo y học: "Anticoagulant properties of drotrecogin alfa (activated) during hemofiltration in patients with severe sepsis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Anticoagulant properties of drotrecogin alfa (activated) during hemofiltration in patients with severe sepsis. | Available online http ccforum.eom content 13 1 113 Commentary Anticoagulant properties of drotrecogin alfa activated during hemofiltration in patients with severe sepsis Anne CJM de Pont and Marcus J Schultz Department of Intensive Care Medicine Academic Medical Center University of Amsterdam Meibergdreef 9 1105 AZ Amsterdam The Netherlands Corresponding author Anne CJM de Pont a.c.depont@amc.uva.nl Published 2 February 2009 This article is online at http ccforum.com content 13 1 113 2009 BioMed Central Ltd Critical Care 2009 13 113 doi 10.1186 cc7684 See related research by Camporota et al. http ccforum.com content 12 6 R163 Abstract In a retrospective study among 35 severely septic patients treated with drotrecogin alfa activated DrotAA and renal replacement therapy RRT Camporota and colleagues demonstrated that the addition of heparin epoprostenol or both to DrotAA during RRT did not improve filter survival. Furthermore in a multivariate logistic regression analysis they identified the minimum value in platelet count as the only predictive factor of filter clotting during DrotAA infusion. These findings are in line with the previously formulated suggestion that DrotAA alone is as effective as heparin in the prevention of coagulation in the extracorporeal circuit. They also confirm the importance of baseline platelet count in the pathogenesis of extracorporeal circuit thrombosis. In the study by Camporata and colleagues DrotAA treatment was not associated with an increase in red blood cell requirements. The results of this study supply a background to clinical decision making when choosing an anticoagulant for RRT in septic patients. In the last 2008 issue of Critical Care Camporota and colleagues 1 reported the results of a retrospective study analyzing filter survival time and transfusion requirements among 35 severely septic patients treated with drotrecogin alfa activated DrotAA and renal replacement therapy RRT . DrotAA is capable of reducing mortality in .