Drotrecogin alfa: a role in emergency department treatment of severe sepsis?
Human protein C is a serine protease that circulates in the blood as an inactive zymogen. It is converted to its active form by interaction with thrombomodulin on the endothelial wall. Activated protein C has a significant role in maintaining haemostasis, and is a major mechanism of controlling microvascular thrombosis. Recent reports describe the use of drotrecogin alfa (recombinant activated protein C) in severe sepsis, a condition relevant to emergency medicine. This review describes the physiology of the protein C pathway and its importance in sepsis. It will also focus on the use of drotrecogin alfa in sepsis, and its use in the ED.
McLeay
Adam M
AM
The Tweed Hospital, Tweed Heads, New South Wales, Australia. amcleay@bigpond.com
D000328:Adult; D000818:Animals; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D002648:Child; D016527:Drug Costs; D004632:Emergency Medical Services / Q000379:methods*; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D018579:Patient Selection; D011486:Protein C / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D018805:Sepsis / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005343:Fibrinolytic Agents; D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated