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 y học đề tài: Clinical review: Drotrecogin alfa (activated) as adjunctive therapy for severe sepsis – practical aspects at the bedside and patient identification Pierre-François Laterre and Xavier Wittebole. | Available online http content 7 6 445 Review Clinical review Drotrecogin alfa activated as adjunctive therapy for severe sepsis - practical aspects at the bedside and patient identification Pierre-Franọois Laterre and Xavier Wittebole Department of Critical Care and Emergency Medicine St Luc University Hospital Brussels Belgium Correspondence Pierre-Franọois Laterre laterre@ Published online 30 June 2003 Critical Care 2003 7 445-450 DOI cc2342 This article is online at http content 7 6 445 2003 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Administration of drotrecogin alfa activated has been demonstrated to reduce mortality in patients with severe sepsis who are at high risk for death or who have multiple organ dysfunction. This benefit was associated with an increased incidence of bleeding events but the latter were mainly procedure related. Drug infusion interruptions should be instituted in accordance with recent recommendations. Monitoring coagulation parameters may help in identifying patients at higher risk for bleeding but it is not indicated to adjust drug dosage. Acute renal failure and hemodialysis are not contraindications to this therapy and no drug dosage adjustment is indicated. Finally the type and source of infection and its anticipated natural history may determine whether drotrecogin alfa activated is indicated as well as the timing of its administration. Keywords drotrecogin alfa activated hemorrhage indication management severe sepsis Introduction In the Recombinant human protein C Worldwide Evaluation in Severe Sepsis PROWESS study 1 recombinant human activated protein C rhAPC drotrecogin alfa activated was shown to reduce 28-day all-cause mortality in patients with severe sepsis. The observed reduction in the relative risk for death was an absolute risk reduction of but this was associated with an increased risk for bleeding events. The US Food and Drug .
