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: Drotrecogin alfa (recombinant human activated protein C) in severe acute pancreatitis. | Available online http content 9 4 321 Commentary Drotrecogin alfa recombinant human activated protein C in severe acute pancreatitis Saurabh Jamdar1 and Ajith K Siriwardena2 1 Research Fellow Hepatobiliary Unit Department of Surgery Manchester Royal Infirmary Manchester UK 2Consultant Surgeon Hepatobiliary Unit Department of Surgery Manchester Royal Infirmary Manchester UK Corresponding author Ajith K Siriwardena Published online 20 July 2005 This article is online at http content 9 4 321 2005 BioMed Central Ltd Critical Care 2005 9 321-322 DOI cc3777 Abstract Introduction Current concepts of the pathophysiology of acute pancreatitis suggest that disease progression from acinar injury to systemic illness involves a complex interplay between cellular and soluble inflammatory mediators and endothelial beds. To date there is no specific pharmacologic intervention for acute pancreatitis. Death from acute pancreatitis remains a major issue and late deaths are often related to haemorrhage and are associated with unresolved intra-abdominal sepsis. Drotrecogin alfa an analogue of endogenous protein C has antithrombotic anti-inflammatory and profibrinolytic properties and it has been shown to reduce mortality in clinical sepsis. Modulation of the coagulation cascade although probably essential to the mode of action of drotrecogin alfa can lead to an increased risk of bleeding. Objective The findings of the PROWESS trial have led to a more widespread use of drotrecogin alfa in sepsis and critically in sepsis-related conditions. The present article provides a concise summary of the interaction between the pathophysiology of acute pancreatitis and the modes of action of drotrecogin alfa placing particular emphasis on the risks related to haemorrhage. Attention is further drawn to the reports of use of drotrecogin alfa in severe acute pancreatitis. Conclusions Synthesis of current knowledge on the modes of action and
