Article Data

  • Views 1819
  • Dowloads 154

Review

Open Access

Human protein C concentrates in adult septic patients

  • GIOVANNI LANDONI1
  • MARTINA CRIVELLARI1
  • GIACOMO MONTI1
  • CHIARA GERLI • PAOLO SILVANI1
  • ALBERTO ZANGRILLO1

1,Department of Cardiothoracic Anesthesia and Intensive Care Istituto Scientifico San Raffaele

DOI: 10.22514/SV32.102008.1 Vol.3,Issue 2,October 2008 pp.13-17

Published: 01 October 2008

*Corresponding Author(s): GIOVANNI LANDONI E-mail: landoni.giovanni@hsr.it

Abstract

Some case reports and case series suggest that protein C concentrates may improve the outcome in patients with congenital or acquired protein C deficiency (not only in those with sepsis induced purpura fulminans). We reviewed the published literature on the use of protein C concentrates in adult septic patients and found that it is limited to less than 70 patients reported in observational studies with a 70% survival, and added our personal experience (two adult patients with sepsis and contraindications to recombinant activated protein C). 

Keywords

sepsis, protein C, cardiac surgery

Cite and Share

GIOVANNI LANDONI,MARTINA CRIVELLARI,GIACOMO MONTI,CHIARA GERLI • PAOLO SILVANI,ALBERTO ZANGRILLO. Human protein C concentrates in adult septic patients. Signa Vitae. 2008. 3(2);13-17.

References

1. Dhainaut JF, Yan SB, Claessens YE. Protein C/activated protein C pathway : Overview of clinical trial results in severe sepsis. Crit Care Med 2004;32:S194-201.

2. Fisher CJ, Yan SB. Protein C levels as prognostic indicator of outcome in sepsis and related diseases. Crit Care Med 2000;28 Suppl 9: S49-56.

3. Fijnvandraat K, Derkx B, Peters M, Bijlmer R, Sturk A, Prins MH, et al. Coagulation activation and tissue necrosis in meningococceal septic shock: severely reduced protein C levels predict a high mortality. Thromb Haemost 1995;73:15-20.

4. Fourrier F, Chopin C, Goudemand J, Hendryex S, Caron C, Rime A, et al. Septic shock, multiple organ failure, and disseminated intravas-cular coagulation. Compared patterns of antithrombin III, protein C, and protein S deficiencies. Chest 1992;101:816-23.

5. Lorente JA, Garcia-Frade LJ, Landin L, de Pablo R, Torrado C, Renes E, et al. Time curse of hemostatic abnormalities in sepsis and relation to outcome. Chest 1993;103:1536-42.

6. Macias WL, Nelson DR. Severe protein C deficiency predicts early death in severe sepsis. Crit Care Med 2004;32:223-8.

7. Deventer SJ, Ten Cate JW. Coagulation activation and tissue necrosis in meningococceal septic shock: severely reduced protein C levels predict a high mortality. Thromb Haemost 1995;73:15-20.

8. Esmon CT. The protein C anticoagulant pathway. Arterioscler Thromb 1992;12:135-45.

9. White B, Livingstone W, Murphy C, Hodgson A, Rafferty M, Smith OP. An open-label study of the role of adjuvant hemostatic support with protein C replacement therapy in purpura fulminans-associated meningococcemia. Blood 2000;96:3719–24.

10. Clarke RC, Johnston JR, Mayne EE. Meningococcal septicemia: treatment with protein C concentrates. Intensive Care Med 2000;26:471–3.

11. De Kleijn ED, De Groot R, Hack CE, H Mulder PG. Activation of protein C following infusion of protein C concentrate in children with severe meningococcal sepsis and purpura fulminans: A randomized, double-blinded, placebo-controlled, dose-finding study. Crit Care Med 2003;31:1839-47.

12. Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, et al. Surviving sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med 2008 Jan; 36:296-327.

13. Gordon RB, Vincent JL, Laterre PF, La Rosa SP. for The Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis (PROWESS) Study Group Efficacy and Safety of Recombinant Human Activated Protein C for Severe Sepsis. New Eng J Med 2001;344:699-709.

14. Abraham E, Laterre PF, Garg R, Levy H, Talwar D, Trzaskoma BL, et al. Drotrecogin alfa (activated) for adults with severe sepsis and low risk of death. N Engl J Med 2005;353:1332-41.

15. Vincent JL, Bernard GR, Beale R, Doig C, Putensen C, Dhainaut JF, et al. Drotrecogin alfa (activated) treatment in severe sepsis from the global-label trial ENHANCE: Further evidence for survival and safety and implication for early treatment. Crit Care Med 2005;33:2266-77.

16. Kanji S, Perreault MM, Chant C, Williamson D, Burry L. Evaluation the use of drotrecogin alfa activated in adult severe sepsis: a Canadian multicenter observational study. Intensive Care Med 2007;33:517-23.

17. Bertolini G, Rossi C, Anghileri A, Livigni S, Addis A, Poole D. Use of drotrecogin alfa (activated) in Italian intensive care units: The results of a nation-wide survey. Intensive Care Med 2007;33:426-34.

18. Crivellari M, Marino G, Landoni G, Belloni I. Administration of human protein C concentrates in patients with double organ failure and severe sepsis after cardiac surgery. Abstract SIAARTI Congress 2008, Palermo. In press.

19. Baratto F, Michielan F, Meroni M, Dal Palù A, Boscolo A, Ori C. Protein C Concentrate to restore physiological values in adult septic patients. Intensive Care Med 2008;34:1707-12.

20. Tuttolomondo A, Pinto A, Di Raimondo D, Fernandez P, Licata G. Plasma derived protein C in severe sepsis: report of two cases. Intern Emerg Med 2008;3:179-82.

21. Schellongowski P, Bauer E, Holzinger U, Staudinger T, Frass M, Laczika K, et al. Treatment of adult patients with sepsis-induced coagu-lopathy and purpura fulminans using a plasma-derived protein C concentrate (Ceprotin). Vox Sang 2006;90:294-301.

22. Fourrier F, Leclerc F, Aidan K, Sadik A, Jourdain M, Tournoys A, et al. Combined antithrombin and protein C supplementation in meningo-coccal purpura fulminans: a pharmacokinetic study. Intensive Care Med 2003;29:1081-7.

23. Makris PE, Girtovitis F, Papadopoulos A, Tamioulaki A, Kosmidou M, Pithara E. Treatment of DIC: the role of PC. J Thromb Haemost 2003 1(Suppl 1):abstract P0600.

24. Vaccarella G, Pelella R. Replacement treatment with protein C in an 18-year-old man with meningococcal sepsis and purpura fulminans. Minerva Anestesiol 2003;69:691-3.

25. Rintala E, Kauppila M, Seppälä OP, Voipio-Pulkki LM, Pettilä V, Rasi V, et al. Protein C substitution in sepsis-associated purpura fulminans. Crit Care Med 2000;28:2373-8.

26. Rintala E, Kauppila M, Seppälä OP, Voipio-Pulkki LM, Pettilä V, Rasi V, et al. Protein C substitution in sepsis-associated purpura fulminans. Critical Care Med 1998;28:2373-8.

27. Baratto F Michielan F, Gagliardi G, Di Gregorio G, Pasqualetto A, Meroni M, et al. Use of protein C concentrate in adult patients with severe sepsis and septic shock. Minerva Anestesiol 2004;70:351-6.

28. Silvani P, Camporesi A, Licari E, Wolfler A. Use of protein C concentrate in pediatric patients with sepsis. Minerva Anestesiol 2005;71:373-8.

29. Spiel AO, Firbas C, Mayr FB, Leitner JM, Schmidt B, Knöbl P, et al. The effects of supra-normal protein C levels on markers of coagulation, fibrinolysis and inflammation in a human model of endotoxemia. Thromb Haemost 2005;94:1148-55.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.3 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top