Guidance on patient identification and administration of recombinant human activated protein C for the treatment of severe sepsis

摘要

Approximately one-third of cases of severe sepsis result in death. Endogenous activated protein C (APC) plays a key role in the regulation of the inflammation, fibrinolysis and coagulation associated with severe sepsis. In a recently published phase III trial, Protein C Worldwide Evaluation in Severe Sepsis (PROWESS), intravenous administration of recombinant human APC (rhAPC) 24 μg/kg/h for 96 h to patients with severe sepsis resulted in a 6.1% reduction in absolute mortality and a 19.4% reduction in the relative risk of death from any cause within 28 days (number needed to treat = 16). This dose is now being applied in clinical practice.