Ramos Guerrero R, López Castilla J D, Atienza Fernández M, Bautista Paloma J, Ramos Guerrero A J, Muñoz Sáez M, Carranza Conde M, Soult Rubio J A
Servicio de Farmacia. Hospital Universitario Virgen del Rocío. Sevilla. Spain.
Farm Hosp. 2003 Nov-Dec;27(6):391-5.
Patients with severe sepsis develop acquired protein C deficiency, and the extent of such deficiency and negative clinical outcomes correlate. Replacing this protein may help prevent such a condition. Two protein C types are commercially available - concentrated and activated proteins. None is registered for the treatment of severe sepsis in the pediatric setting. Experience with protein C in this group of conditions is limited. Appropriate clinical trials are required to establish effectiveness and safety, and to elucidate the role of either protein C type in the management of this condition in the pediatric setting. This paper discusses experience with the use of protein C concentrate as an adjuvant treatment in addition to conventional therapy in three children with severe sepsis at a Pediatric Intensive Care Unit. In all 3 cases of our study, high levels of protein C correlated to coagulation parameter normalization and reduced dimer D levels. Two out of three had a favorable outcome following treatment, whereas the third patient died as a result of septic shock and multiple organ dysfunction.
严重脓毒症患者会出现获得性蛋白C缺乏，且这种缺乏的程度与不良临床结局相关。补充这种蛋白可能有助于预防此类病症。有两种商用蛋白C制剂——浓缩蛋白C和活化蛋白C。在儿科领域，尚无这两种制剂被注册用于治疗严重脓毒症。在这组病症中使用蛋白C的经验有限。需要进行适当的临床试验来确定其有效性和安全性，并阐明这两种蛋白C制剂在儿科治疗该病症中的作用。本文讨论了在一家儿科重症监护病房，将蛋白C浓缩物作为常规治疗之外的辅助治疗用于三名严重脓毒症患儿的经验。在我们研究的所有3例病例中，蛋白C水平升高与凝血参数正常化及D - 二聚体水平降低相关。三名患者中有两名治疗后预后良好，而第三名患者因感染性休克和多器官功能障碍死亡。
