title: Nonactivated Protein C in the Treatment of Neonatal Sepsis: A Retrospective Analysis of Outcome.
abstract: Previously, we found that plasma protein C (PC) activity ≤10% significantly increased the probability of the occurrence of death during neonatal sepsis. Accordingly, if the activity of plasma PC declined during the course of sepsis to ≤10%, we administered a nonactivated PC zymogen to increase a PC activity. The aim of that retrospective analysis was to explore treatment effects of PC zymogen supplementation in septic infants, with plasma PC activity ≤10%.
  
  
  
  A database was used to locate 85 newborns treated with PC from among 458 analyzed infants with confirmed sepsis.
  
  
  
  The median birth weight and gestational age of treated infants were, respectively, 1010.0 g and 29 weeks. In 47 infants, early-onset sepsis developed, whereas in 38 neonates, late-onset sepsis was recognized. PC was given as a single dose of 200 IU/kg. Among 458 septic patients, death occurred in 19 newborns (4.2%), exclusively in infants with plasma PC activity ≤10%. In 15 infants, death occurred in the course of early-onset sepsis and 4 newborns died of late-onset sepsis (early-onset sepsis vs. late-onset sepsis; P = 0.036; χ with the Yates correction).
  
  
  
  An increased risk of death in septic neonates with plasma PC activity ≤10% suggests the necessity for its evaluation and possibility of supplementation of PC zymogen.
authors.affiliation: From the Department of Neonatology, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Ryszard
authors.initials: R
authors.lastname: Lauterbach
authors.forename: Barbara
authors.initials: B
authors.lastname: Wilk
authors.forename: Agata
authors.initials: A
authors.lastname: Bocheńska
authors.forename: Joanna
authors.initials: J
authors.lastname: Hurkała
authors.forename: Renata
authors.initials: R
authors.lastname: Radziszewska
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D000071074:Neonatal Sepsis / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality*; D011486:Protein C / Q000032:analysis / Q000378:metabolism / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D011486:Protein C