title: [Activated C protein in the treatment of a newborn with sepsis, shock and multiple organ dysfunction systems: case report and literature review].
abstract: OBJECTIVE
  Severe sepsis represents the systemic inflammatory response resulting from an infection, associated with one of the following: cardiovascular organ dysfunction, acute respiratory distress syndrome or two or more organ dysfunctions. Although the mortality rate from sepsis in children has steadily decreased in the last decades, the mortality rate in newborns remains high (20% to 40%) despite the development in intensive care. The authors describe a newborn who suffered from sepsis, shock and multiple organ dysfunction syndromes (MODS) that recovered after the administration of activated C protein.
  
  
  METHODS
  A premature newborn underwent cesarean section because of a premature rupture of membranes and acute fetal distress. The newborn developed acute respiratory distress due to intrauterine pneumonia and was taken to the Neonatal Intensive Care Unit. The patient was given mechanical ventilation, exogenous pulmonary surfactant and antibiotics early in the treatment. Nevertheless, he developed persistent pulmonary hypertension and shock. The control of the infection was difficult, despite the adjustment of the antibiotics, resulting in the development of MODS. On the 28th day, activated C protein was given to the patient. The administration of the drug was successful and the patient recovered from the organ dysfunction without bleeding.
  
  
  CONCLUSIONS
  The activated C protein can't be recommended as a routine in the treatment of newborns with severe sepsis. However, in this case, it contributed to the recovery of the organ dysfunctions presented by the patient.
authors.affiliation: Unidades de Terapia Intensiva Neonatal, Hospitais Santa Elisa e Universitário, Faculdade de Medicina de Jundiaí.
authors.forename: Flávia Carolina Davini
authors.initials: FC
authors.lastname: Georgetti
authors.affiliation: Unidades de Terapia Intensiva Neonatal, Hospitais Santa Elisa e Universitário, Faculdade de Medicina de Jundiaí.
authors.forename: Gisela de Rezende
authors.initials: Gde R
authors.lastname: Eugênio