Drotrecogin alfa (activated): real-life use and outcomes for the UK.

Critical Care : the Official Journal of the Critical Care Forum
K RowanDavid A Harrison

Abstract

In March 2001, the results of the Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study were published, which indicated a 6.1% absolute reduction in 28-day mortality. Drotrecogin alfa (activated; DrotAA) was subsequently approved for use in patients with severe sepsis. In December 2002, critical care units in England, Wales and Northern Ireland were invited to participate in an audit of DrotAA. Data for each infusion of DrotAA were linked to case mix and outcome data from a national audit. Use of DrotAA was described and a nonrandomized comparison of effectiveness was conducted. 1,292 infusions of DrotAA were recorded in 112 units; 61% commenced during the first 24 hours in the unit. The majority (77%) of patients had three or more organs failing; lung (42%) and abdomen (40%) were the most common primary sites of infection. Crude hospital mortality was high (45%); at 28 days, only 18% had left acute hospital and 19% were still in the unit. For 30%, the full 96-hour infusion was not completed; 24% of infusions were interrupted; 8.1% experienced one or more serious adverse events, of which 77% were serious bleeding events. Of eight relative risks estimated from individually-matched (0.75 to 0...Continue Reading

References

Mar 10, 2001·The New England Journal of Medicine·G R BernardUNKNOWN Recombinant human protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study group
Sep 27, 2002·The New England Journal of Medicine·H Shaw WarrenRobert S Munford
Sep 27, 2002·The New England Journal of Medicine·Jay P Siegel
Sep 27, 2002·The New England Journal of Medicine·E Wesley ElyJean-Louis Vincent
Jan 25, 2003·Critical Care Medicine·E Wesley ElyUNKNOWN PROWESS Investigators
Apr 25, 2003·Intensive Care Medicine·Jean-François DhainautUNKNOWN Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis (PROWESS) Study Group
Apr 20, 2004·Critical Care Medicine·Derek C AngusUNKNOWN Robert Wood Johnson Foundation ICU End-Of-Life Peer Group
Sep 30, 2005·The New England Journal of Medicine·Edward AbrahamUNKNOWN Administration of Drotrecogin Alfa (Activated) in Early Stage Severe Sepsis (ADDRESS) Study Group
Oct 20, 2006·The New England Journal of Medicine·Peter Q EichackerRobert L Danner
Sep 8, 2007·Critical Care : the Official Journal of the Critical Care Forum·Jean-François DhainautUNKNOWN PREMISS Study Group
Oct 5, 2010·Injury Prevention : Journal of the International Society for Child and Adolescent Injury Prevention·P CummingsL Quan

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Citations

Oct 8, 2008·Intensive Care Medicine·Daniel A SweeneyCharles Natanson
Aug 7, 2010·Intensive Care Medicine·Etienne GayatRaphaël Porcher
Aug 9, 2008·Current Infectious Disease Reports·Philip S Barie
Aug 9, 2013·Current Infectious Disease Reports·Peggy S Lai, B Taylor Thompson
May 5, 2012·BMC Musculoskeletal Disorders·Jeffrey G JarvikRichard A Deyo
Sep 29, 2011·Critical Care : the Official Journal of the Critical Care Forum·M Zia SadiqueKathryn M Rowan
Jul 2, 2009·Critical Care : the Official Journal of the Critical Care Forum·Greg MartinRichard Beale
Jun 15, 2013·Therapeutics and Clinical Risk Management·Kevin E AngerPaul M Szumita
Jul 8, 2010·Annals of Plastic Surgery·Elizabeth ChippAdam V Blackburn
Mar 26, 2010·Critical Care Medicine·Andre C Kalil
May 29, 2009·European Journal of Anaesthesiology·David Pestaña, Raquel Ramos
Jul 20, 2012·The Lancet Infectious Diseases·Andre C Kalil, Steven P LaRosa
Jun 14, 2012·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Noemi KreifJasjeet S Sekhon
Feb 2, 2018·Annals of Intensive Care·Djillali AnnaneJames A Russell
Aug 6, 2013·American Journal of Physiology. Lung Cellular and Molecular Physiology·Sarah C ChristiaansJean Francois Pittet

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Software Mentioned

ENHANCE
PROWESS
DrotAA
Stata

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