#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Is haemocoagulation inhibitor therapy in sepsis appropriate?


Authors: J. Blatný;  O. Zapletal
Authors‘ workplace: Oddělení klinické hematologie, Fakultní nemocnice Brno
Published in: Anest. intenziv. Med., 19, 2008, č. 1, s. 12-15
Category: Intensive Medicine

Overview

This review focuses on the problems and questions regarding the treatment of septic patients using coagulation inhibitor concentrates from the haematologist’s point of view. Currently available published data are reviewed and summarised and on its basis recommendations for the administration of commercially available coagulation inhibitor concentrates (mainly AT, PC, aPC and heparins) are formulated.

Key words:
sepsis  coagulation – antithrombin – heparin – protein C – bleeding – thrombosis


Sources

1. van der Poll, T. Coagulation and inflammation. J. Endotoxin. Res., 2001, 7, 4, p. 301–304.

2. Kolde, H. J. Haemostasis. 2nd edition, 2004.

3. Nathan and Oski’s hematology of infanty and childhood. 6th edition.

4. Hoffmann, J. N., Wiedermann, C. J., Juers, M., Ostermann, H., Kienast, J., Briegel, J., Strauss, R., Warren, B. L., Opal, S. M. KyberSept investigators, Benefit/risk profile of high-dose antithrombin in patients with severe sepsis treated with and without concomitant heparin. Thromb. Haemost., 2006, 95, p. 850–856.

5. Bucur, S. Z., Levy, J. H., Despotis, G. J., Spiess, B. D., Hillyer, C. D. Uses of antithrombin III concentrate in congenital and acquired deficiency states. Transfusion, 1998, 38, p. 481–498.

6. Sorg, H., Hoffmann, J. N., Menger, M. D., Lindenblatt, N., Goehring, P., Vollmar, B. Antithrombin is as effective as heparin and hirudin to prevent formation of microvascular thrombosis in a murine model. Thromb. Haemost., 2006, 96, p. 371–377.

7. Drotrecogin alfa: a second look. More clinical trials in severe sepsis: mostly negative results. Prescrire Int., 2007, 16, 87, p. 7–9.

8. McCoy, C. Safety of drotrecogin alfa (activated) in the treatment of patients with severe sepsis. Expert Opin. Drug Saf., 2004, 3, 6, p. 625–637.

9. Haley, M., Cui, X., Minneci, P. C., Deans, K. J., Natanson, C., Eichacker, P. Q. Recombinant human activated protein C in sepsis: assessing its clinical use. Am. J. Med. Sci., 2004, 328, p. 215–219.

10. Nadel, S., Goldstein, B., Williams, M. D., Dalton, H., Peters, M., Macias, W. L., Abd-Allah, S. A., Levy, H., Angle, R., Wang, D., Sundin, D. P., Giroir, B. REsearching severe Sepsis and Organ dysfunction in children: a gLobal perspectiVE (RESOLVE) study group., Drotrecogin alfa (activated) in children with severe sepsis: a multicentre phase III randomised controlled trial. Lancet, 2007, 10, 369, 9564, p. 836–843.

11. Levi, M., Levy, M., Williams, M. D., Douglas, I., Artigas, A., Antonelli, M., Wyncoll, D., Janes, J., Booth, F. V., Wang, D., Sundin, D. P., Macias, W. L., for the Xigris and Prophylactic HepaRin Evaluation in Severe Sepsis (XPRESS) Study Group. Prophylactic heparin in patients with severe sepsis treated with drotrecogin alfa (activated). Am. J. Respir. Crit. Care Med., 2007, 176, p. 483–490. (Epub 2007 Jun 7)

12. Ettingshausen, C. E., Veldmann, A., Beeg, T., Schneider, W., Jager, G., Kreuz, W. Replacement therapy with protein C concentrate in infants and adolescents with meningococcal sepsis and purpura fulminans. Semin. Thromb. Hemost., 1999, 25, p. 537–541.

13. Kreuz, W., Veldmann, A., Fischer, D., Schlosser, R., Volk, W. R., Ettingshausen, C. E. Neonatal sepsis: a challenge in hemostaseology. Semin. Thromb. Hemost., 1999, 25, p. 531–535.

14. Smith, O. P., White, B., Vaughan, D., Rafferty, M., Claffey, L., Lyons, B., Casey, W. Use of protein-C concentrate, heparin, and haemodiafiltration in meningococcus-induced purpura fulminans. Lancet, 1997, 29, 350, 9091, p. 1590–1593.

15. de Kleijn, E. D., de Groot, R., Hack, C. E., Mulder, P. G., Engl, W., Moritz, B., Joosten, K. F., Hazelzet, J. A. 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, p. 1839–1847.

16. Robertson, M. S. Heparin: the cheap alternative for immunomodulation in sepsis? Crit. Care Resusc., 2006, 8, 3, p. 235–238.

17. Warren, B. L., Eid, A., Singer, P., Pillay, S. S., Carl, P., Novak, I., Chalupa, P., Atherstone, A., Penzes, I., Kubler, A., Knaub, S., Keinecke, H. O., Heinrichs, H., Schindel, F., Juers, M., Bone, R. C., Opal, S. M., KyberSept Trial Study Group. Caring for the critically ill patient. High-dose antithrombin III in severe sepsis: a randomized controlled trial. JAMA, 2001, 286, p. 1869–1878. (Erratum in: JAMA 2002, 287, p. 192)

Labels
Anaesthesiology, Resuscitation and Inten Intensive Care Medicine
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#