Recombinant Human Activated Protein C for Adults with Septic Shock. A Randomized Controlled Trial

Annane, Djillali; Timsit, Jean‐François; Mégarbane, Bruno; Martin, Claude; Misset, Benoît; Mourvillier, Bruno; Siami, Shidasp; Chagnon, Jean-Luc; Constantin, Jean-Michel; Petitpas, Franck; Souweine, Bertrand; Amathieu, Roland; Forceville, Xavier; Charpentier, Claire; Tesnière, Antoine; Chastre, Jean; Bohé, Julien; Colin, Gwenhaël; Cariou, Alain; Renault, Alain; Brun‐Buisson, Christian; Bellissant, Éric

doi:10.1164/rccm.201211-2020oc

Cited by 74 publications

(54 citation statements)

References 21 publications

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“…7,8 However, none of the new adjunctive agents for sepsis therapy has improved survival rates in a consistent way. 9 The biology of sepsis includes inflammation, immune paralysis, apoptotic cell death, mitochondrial dysfunction, and microcirculatory derangement involving multiple pathways. Numerous studies have tested the efficacy and effectiveness of immunosuppression agents, but their impact has been frustratingly modest, and currently none is approved for clinical use.…”

Section: Introductionmentioning

confidence: 99%

Impact of Statins in Outcomes of Septic Patients: A Systematic Review

Tralhão

Souza-Dantas

Salluh

et al. 2014

Postgraduate Medicine

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Section: Introductionmentioning

confidence: 99%

Impact of Statins in Outcomes of Septic Patients: A Systematic Review

Tralhão

Souza-Dantas

Salluh

et al. 2014

Postgraduate Medicine

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“…A meta-analysis reported by Kalil et al [18] in 2012 confirmed these results, with an 18% decrease in relative risk of mortality. Subsequently, however, two studies, performed by Annane et al [19] and Ranieri et al [20], respectively, showed that drotrecogin alfa (activated) provided no benefit in critically patients with septic shock and increased the severity of their illness. The use of drotrecogin alfa (activated) can no longer be recommended in the management of sepsis, no matter what its degree of severity.…”

Section: Drotrecogin Alfa (Activated)mentioning

confidence: 99%

Management of Infections in Critically Ill Patients

Hranjec

Sawyer

2014

Surgical Infections

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Background: Critically ill patients have an increased risk of developing infections and infectious complications, sometimes followed by death. Despite a substantial investment of resources in outcomes improvement, optimum treatment for such patients remains unclear for practicing intensivists. Methods: We conducted a review that highlights the most recent developments in the prevention, diagnosis, and management of infection and the evaluation of its outcomes. The review examines the prevention of infection, such as through daily bathing with chlorhexidine and the addition of probiotics to treatment regimens, and questions the previous standards of care, including the monitoring of gastric residuals and treatment of severely ill patients with drotrecogin alfa (activated). It also discusses novel approaches to the treatment of severely ill infected patients with extra-corporeal membrane oxygenation and the earlier normalization of body temperature. Results: The development of new antibiotics continues at a slow pace, with the likelihood that alternative approaches to the management of infection, including changes in the quality of patient care, are producing needed improvements. Conclusions: Clinical outcomes of infection are improving slowly as medical teams strive for better patient care. Lack of reimbursement is unnecessary as a punitive approach to infectious diseases.

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“…Ciddi septik şok'lu yetişkinlerde, drotrecogin alfa aktive (DAA) fayda veya zararla ilgili hiçbir kanıt bulunmamıştır 26 .…”

Section: Vasopressör Ve İnotropik Destekunclassified

Sepsiste Hemodinamik Destek

Yıldız¹,

Karakoç²

2014

Arşiv Kaynak Tarama Dergisi

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Sepsis is called systemic inflammatory response syndrome due to infection. When added to organs failure and perfusion abnormality is defined in severe sepsis, Hypotension that do not respond to fluid therapy is as defined septic shock. Fluid resuscitation is a most important parts of the treatment in patients with septic shock. Ongoing hypotension that despite of the adequate fluid therapy, vasopressor support initiation is required. The different approaches to the development of methods to track and objective comes up. Patients with severe sepsis and septic shock should be followed in the intensive care unit and rapid fluid replacement and effectual hemodynamic support should be provided. Key words: Hemodynamic support, monitoring, sepsis, shock. ÖZET Sepsis, enfeksiyona bağlı gelişen sistemik inflamatuar yanıt sendromu olarak adlandırılır. Organ yetmezliği ve perfüzyon bozukluğu bulguları tabloya eklendiği zaman ağır sepsis, sıvı tedavisine cevapsız hipotansiyon geliştiğinde septik şok olarak tanımlanmaktadır. Sıvı resüsitasyonu septik şoktaki hastalarda tedavinin en önemli kısımlarından biridir. Yeterli sıvı desteğine rağmen devam eden hipotansiyon, vasopressör tedavisinin başlanmasını gerektirir. Objektif takip yöntemlerinin geliştirilmesi sonucu farklı yaklaşımlar gündeme gelmektedir. Ağır sepsis ve septik şoklu hastalar yoğun bakımda izlemelidir ve en kısa sürede hızlı sıvı replasmanı ve etkin hemodinamik destek sağlanmalıdır.

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Recombinant Human Activated Protein C for Adults with Septic Shock. A Randomized Controlled Trial

Abstract: In adults with established and severe septic shock, DAA showed no evidence of benefit or harm. Clinical trial registered with www.clinicaltrials.gov (NCT00625209).

Cited by 74 publications

References 21 publications

Impact of Statins in Outcomes of Septic Patients: A Systematic Review

Impact of Statins in Outcomes of Septic Patients: A Systematic Review

Management of Infections in Critically Ill Patients

Sepsiste Hemodinamik Destek

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