Coagulopathy and the role of recombinant human activated protein C in sepsis and following polytrauma.
Recombinant human activated protein C (rhAPC) also known as drotrecogin alfa (activated) has known antithrombotic, anti-inflammatory, and profibrinolytic properties in severe sepsis. Treatment with rhAPC (Xigris) has been shown to reduce mortality in patients with severe sepsis. The lack of any trials of rhAPC in trauma patients means that a definitive recommendation regarding its use in the polytraumatised patient, in whom severe head trauma or other contraindications for the use of rhAPC have been excluded remains controversial at present. This article describes the current evidence of its efficacy and safety in severe sepsis with relation to surgery and trauma.
Dahabreh
Ziad
Z
St James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
Dimitriou
Rozalia
R
Chalidis
Byron
B
Giannoudis
Peter V
PV
D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D009026:Mortality; D011486:Protein C / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D012449:Safety; D018805:Sepsis / Q000150:complications / Q000188:drug therapy*; D013514:Surgical Procedures, Operative; D014947:Wounds and Injuries / Q000150:complications*
D005343:Fibrinolytic Agents; D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated