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Intensive Care Medicine

Erschienen in:

01.07.2009 | Original

Reversal of refractory septic shock with drotrecogin alpha (activated)

verfasst von: A. Vieillard-Baron, V. Caille, C. Charron, G. Belliard, P. Aegerter, B. Page, F. Jardin

Erschienen in: Intensive Care Medicine | Ausgabe 7/2009

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Abstract

Objective

We previously reported that early continuous veno-venous hemodiafiltration (CVVHDF) enables rapid identification of a subgroup of patients with “refractory” septic shock and a 100% risk of death. The objective of this study was to investigate whether early administration of drotrecogin alpha (activated) (DrotAA) to this selected subgroup of septic patients at extremely high risk of death would significantly improve prognosis.

Method

Prospective observational study in a medical intensive-care unit of a University Hospital. Twenty-three patients with refractory septic shock were included. “Refractory” shock was defined as persistent circulatory failure despite adequate circulatory support, associated with persisting lactic acidosis despite early CVVHDF. Response to CVVDHF was assessed after 6 h of this continuous procedure. Patients selected by this strategy received DrotAA infusion for four days.

Results

The 28-day mortality rate of the 23 patients was 39%. No difference was observed at inclusion between survivors and nonsurvivors. In patients who finally survived, 12 h of DrotAA infusion was associated with a significant decrease in lactic acidosis and in norepinephrine dose.

Conclusion

DrotAA therapy was associated with unexpectedly high 28-day survival in patients with “refractory” septic shock.

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Titel: Reversal of refractory septic shock with drotrecogin alpha (activated)
verfasst von: A. Vieillard-Baron
V. Caille
C. Charron
G. Belliard
P. Aegerter
B. Page
F. Jardin
Publikationsdatum: 01.07.2009
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 7/2009
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1538-9

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Reversal of refractory septic shock with drotrecogin alpha (activated)

Abstract

Objective

Method

Results

Conclusion

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Springer Medizin

Abstract

Objective

Method

Results

Conclusion

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