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: Drotrecogin alfa (activated) may attenuate severe sepsis-associated encephalopathy in clinical septic shock. | Spapen et al. Critical Care 2010 14 R54 http content 14 2 R54 RESEARCH Open Access Drotrecogin alfa activated may attenuate severe sepsis-associated encephalopathy in clinical septic shock Herbert Spapen 1 Duc Nam Nguyen1 Joris Troubleyn1 Luc Huyghens1 and Johan Schiettecatte2 Abstract Introduction Sepsis-associated encephalopathy SAE is a diffuse cerebral dysfunction induced by the immuno-inflammatory response to infection. Elevated levels of the brain-specific S100B protein are present in many septic patients and reflect the severity of SAE. Adjunctive treatment with drotrecogin alfa activated DrotAA the human recombinant form of activated protein C has been shown to improve mortality in patients with severe sepsis-induced organ failure. We studied the effect of DrotAA on S100B levels in patients with acute septic shock who presented with increased baseline values of this biomarker. Methods All patients received standard goal-directed resuscitation treatment. Patients with pre-existing or acute neurological disorders were excluded. Based on the Glasgow coma scale GCS patients were classified into two groups GCS 13 and GCS 13. DrotAA was given as a continuous infusion of 24 pg kg h for 96 h. S100B was measured before sedation and the start of DrotAA 0 h and at 32 h 64 h and 96 h and at corresponding time points in patients not treated with DrotAA. The lower limit of normal was pg L. Results Fifty-four patients completed the study. S100B was increased in 29 54 patients. Twenty-four patients 9 with GCS 13 and 15 with GCS 13 received DrotAA. S100B levels in DrotAA-treated patients with a GCS 13 though higher at baseline than in untreated subjects pg L vs. pg L P progressively and significantly decreased during infusion pg L at 32 h P pg L at 64 h P and pg L at 96 h P vs. baseline . This patient group had also significantly lower S100B values at 64 h and at 96 h than their untreated .
