Severe sepsis: patient management focusing on administration of drotrecogin alpha (activated) infusion.
This article presents a case study of a 49-year-old male admitted to the Intensive Care Unit (ICU) via Accident and Emergency following a collapse at home with a diagnosis of severe sepsis. The pathophysiology of sepsis is discussed together with a physiological assessment of the patient's cardiovascular, respiratory and renal systems, coagulation and metabolic responses. The discussion focuses on the period from ICU admission to commencement of drotrecogin alpha (activated) treatment (also known as recombinant human activated protein C). The management of sepsis and the treatment the patient received are outlined with particular focus on the strategic and procedural issues of the drug administration. The article concludes by presenting nursing clinical guidelines which will provide helpful guidance for nurses when caring for patients receiving drotrecogin alpha (activated) treatment. This is especially welcome, as drotrecogin alpha (activated) is internationally recommended in the treatment of severe sepsis.
Riddell
Caroline
C
Intensive Care Unit, Ulster Hospital, Dundonald, UK. mridd@allstate.com
Blackwood
Bronagh
B
D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods* / Q000592:standards; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D014943:Global Health; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous / Q000451:nursing; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009730:Nursing Assessment / Q000379:methods; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011486:Protein C / Q000009:adverse effects / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D017751:Safety Management; D018805:Sepsis / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D012720:Severity of Illness Index
D000890:Anti-Infective Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005343:Fibrinolytic Agents; D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated