Recombinant human activated protein C treatment of septic shock syndrome in a patient at 18th week of gestation: A case report

Medve, László; Csitári, István Kis; Molnár, Zsolt; László, Ádám

doi:10.1016/j.ajog.2005.04.046

Cited by 15 publications

(4 citation statements)

References 3 publications

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“…4 There have been reports of rhAPC use in pregnancy and the peripartum period. 11,12 When intravenous immunoglobulin was given to our patient, the evidence for its efficacy was anecdotal, with one small observational study demonstrating a reduced mortality in patients receiving it. A recent meta-analysis of its use in severe sepsis and septic shock showed a reduction in mortality, with a number needed to treat of 9.27.…”

Section: Discussionmentioning

confidence: 96%

Puerperal streptococcal toxic shock syndrome treated with recombinant human activated protein C and intravenous immunoglobulin

Al-Rawi

Woodward

Knight

2009

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 96%

Puerperal streptococcal toxic shock syndrome treated with recombinant human activated protein C and intravenous immunoglobulin

Al-Rawi

Woodward

Knight

2009

International Journal of Obstetric Anesthesia

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“…The drug is currently licensed only for the FDA approved indication -severe sepsis in the adult patient with high mortality risk. There is only one case report of its use in a pregnant 19 year old woman at 18 weeks of gestation, who had septic shock with no adverse e ects on mother or fetus (Medve 2005). The mortality rates of severe sepsis in children are much lower than in adults with severe sepsis (ranging from 7% to 12%) (Kutko 2003).…”

Section: Discussionmentioning

confidence: 99%

Recombinant human activated protein C for severe sepsis in neonates

Kylat

Ohlsson

2012

Cochrane Database of Systematic Reviews

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Cochrane Database of Systematic Reviews Main results No eligible trials were identified. In October 2011 rhAPC (Xigris®) was withdrawn from the market by Eli Lilly due to a higher mortality in a trial among adults. Xigris® (DrotAA)(rhAPC) should no longer be used in any age category and the product should be returned to the distributor. Authors' conclusions Despite the scientific rationale for its use, there is insu icient data to use rhAPC for the management of severe sepsis in newborn infants. Due to the results among adults with lack of e icacy, an increase in bleeding and resulting withdrawal of rhAPC from the market, neonates should not be treated with rhAPC and further trials should not be conducted.

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“…25 Activated protein C is not well studied in pregnancy, but case reports do exist. 95,96 Pneumonia Prevalence and hospitalization rates for pneumonia are similar between pregnant and nonpregnant controls. 97 However, respiratory failure due to pneumonia was the third leading indication for intubation during pregnancy and accounted for 12% of intubated obstetric patients in one series.…”

Section: General Management Principlesmentioning

confidence: 96%

The Management of the Critically Ill Obstetric Patient

Honiden

Abdel-Razeq

Siegel

2011

J Intensive Care Med

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Hypertensive disorders, postpartum hemorrhage, and sepsis are the most common indications for intensive care unit admission among obstetric patients. In general, ICU mortality is low, and better than would be predicted using available mortality prediction tools. Provision of care to this special population requires an intimate understanding of physiologic changes that occur during pregnancy. Clinicians must be aware of the way various diagnostic and treatment choices can affect the mother and fetus. Most clinically necessary radiographic tests can be safely performed and fall under the maternal radiation exposure limit of less than 0.05 Gray (Gy). Careful attention must be paid to acid-base status, oxygenation, and ventilation when faced with respiratory failure necessitating intubation. Cesarean delivery can be justified after 4 minutes of cardiac arrest and may improve fetal and maternal outcomes. The treatment of obstetric patients in the ICU introduces complexities and challenges that may be unfamiliar to many critical care physicians; teamwork and communication with obstetricians is crucial.

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Recombinant human activated protein C treatment of septic shock syndrome in a patient at 18th week of gestation: A case report

Cited by 15 publications

References 3 publications

Puerperal streptococcal toxic shock syndrome treated with recombinant human activated protein C and intravenous immunoglobulin

Puerperal streptococcal toxic shock syndrome treated with recombinant human activated protein C and intravenous immunoglobulin

Recombinant human activated protein C for severe sepsis in neonates

The Management of the Critically Ill Obstetric Patient

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