PURPOSE: The aim of this study was to assess the relationship between protein C levels and temporal changes in organ dysfunction. MATERIALS AND METHODS: Using data from the placebo arm of Recombinant Human Activated PROtein C Worldwide Evaluation in Severe Sepsis trial (N = 775), we compared the development of organ dysfunction over time, in adult severe sepsis patients with and without severe protein C deficiency. RESULTS: At study enrollment (baseline), patients with and without severe protein C deficiency were similar in age and likelihood of comorbidities. Patients with severe protein C deficiency had lower arterial blood pressure (P = .0006), greater serum creatinine concentration (P < .0001), elevated markers of thrombosis and inflammation, and impairment of fibrinolysis (P < .0001). The baseline PaO(2)/FiO(2) ratio was not significantly different between the 2 groups. Seven days after study enrollment, cardiovascular and renal function remained significantly worse in patients with severe protein C deficiency (P < .0001), and respiratory dysfunction was greater (P < .0001). Baseline protein C deficiency was seen to be associated with subsequent pulmonary, renal, and hematologic organ failure. CONCLUSIONS: Severe protein C deficiency in patients with severe sepsis is associated with both the incidence and severity of organ dysfunction and subsequent worsening of organ function and may be a useful predictor of organ failure in severe sepsis.
RCT Entities:
PURPOSE: The aim of this study was to assess the relationship between protein C levels and temporal changes in organ dysfunction. MATERIALS AND METHODS: Using data from the placebo arm of Recombinant Human Activated PROtein C Worldwide Evaluation in Severe Sepsis trial (N = 775), we compared the development of organ dysfunction over time, in adult severe sepsispatients with and without severe protein C deficiency. RESULTS: At study enrollment (baseline), patients with and without severe protein C deficiency were similar in age and likelihood of comorbidities. Patients with severe protein C deficiency had lower arterial blood pressure (P = .0006), greater serum creatinine concentration (P < .0001), elevated markers of thrombosis and inflammation, and impairment of fibrinolysis (P < .0001). The baseline PaO(2)/FiO(2) ratio was not significantly different between the 2 groups. Seven days after study enrollment, cardiovascular and renal function remained significantly worse in patients with severe protein C deficiency (P < .0001), and respiratory dysfunction was greater (P < .0001). Baseline protein C deficiency was seen to be associated with subsequent pulmonary, renal, and hematologic organ failure. CONCLUSIONS: Severe protein C deficiency in patients with severe sepsis is associated with both the incidence and severity of organ dysfunction and subsequent worsening of organ function and may be a useful predictor of organ failure in severe sepsis.
Authors: Liesbeth M Kager; W Joost Wiersinga; Joris J T H Roelofs; Onno J de Boer; Hartmut Weiler; Cornelis van 't Veer; Tom van der Poll Journal: PLoS Negl Trop Dis Date: 2014-04-24
Authors: Johannes Daan de Boer; Liesbeth M Kager; Joris J T H Roelofs; Joost C M Meijers; Onno J de Boer; Hartmut Weiler; Berend Isermann; Cornelis van 't Veer; Tom van der Poll Journal: BMC Infect Dis Date: 2014-11-04 Impact factor: 3.090
Authors: Mirjam Bachler; Lars M Asmis; Jürgen Koscielny; Thomas Lang; Hartmuth Nowak; Patrick Paulus; Jens-Christian Schewe; Christian von Heymann; Dietmar Fries Journal: Blood Coagul Fibrinolysis Date: 2022-06-08 Impact factor: 1.061