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Báo cáo y học: "Human protein C concentrate in the treatment of purpura fulminans: a retrospective analysis of safety and outcome in 94 pediatric patient"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Human protein C concentrate in the treatment of purpura fulminans: a retrospective analysis of safety and outcome in 94 pediatric patients. | Veldman et al. Critical Care 2010 14 R156 http ccforum.eom content 14 4 R156 c CRITICAL CARE RESEARCH Open Access Human protein C concentrate in the treatment of purpura fulminans a retrospective analysis of safety and outcome in 94 pediatric patients A Izxxz Ỉ r I z l m x zx 1 A Z X z I r c I r r Lx zx z2 c I fX Z í Ạ zx zx zx 1 A I IPLx -X l zzxi i-72Oi k zxl c x r r zx3 Ozi I zx fx c Lxzxzr zxR r Lx zxz4 Alex veldman Doris Fischer Flora Y Wong vvoiTnan Kreuz Micnaei sasse Bruno tberspacher Ulrich Mansmann5 Rudolf Schosser4 Abstract Introduction Purpura Tulminans PF is a devastating complication of uncontrolled systemic inflammation associated with high incidence of amputations skin grafts and death. In this study we aimed to clarify the clinical profile of pediatric patients with PF who improved with protein C PC treatment explore treatment effects and safety and to refine the prognostic significance of protein C plasma levels. Methods In Germany patients receiving protein C concentrate Ceprotin Baxter AG Vienna Austria are registered. The database was used to locate all pediatric patients with PF treated with PC from 2002 to 2005 for this national retrospective multi-centered study. Results Complete datasets were acquired in 94 patients treated in 46 centers with human non-activated protein C concentrate for purpura fulminans. PC was given for 2 days median range 1-24 days with a median daily dose of 100 lU kg. Plasma protein C levels increased from a median of 27 to a median of 71 under treatment. 22.3 of patients died 77.7 survived to discharge. Skin grafts were required in 9.6 amputations in 5.3 . PF recovered or improved in 79.8 remained unchanged in 13.8 and deteriorated in 6.4 . Four adverse events occurred in 3 patients none classified as severe. Non-survivors had lower protein C plasma levels P 0.05 and higher prevalence of coagulopathy at admission P 0.01 . Time between admission and start of PC substitution was longer in patients who died compared to