Abstract
Sepsis results in pronounced hypercoagulability due to the strong activation of coagulation, depletion of anticoagulant factors and impairment of normal fibrynolitic response. Protein C (PC) is a natural anticoagulant and also has important anti-inflammatory activity. We reports the effects of substitution with a human, virus- inactivated protein C concentrate (Ceprotin®) in neonatal sepsis. Design:case series. Setting: open-label, non randomized study conducted in 6 neonatal care units. Objectives: To perform a preliminary analysis of the clinical and laboratory effects of PC concentrate as an adjunt to conventional therapy in the treatment of sepsis-induced coagulopathy. Patients: 11 neonates with a median gestational age of 31 week (range: 26 to 40W) 4F/7M, median birth weight of 1034 g (range: 586 to 3350) received an initial intravenous bolus of 100 IU/kg followed by 50 IU/kg six time per day. All patients presented with low plasma PC acitivity prior treatment (median: 18,1%, range 10% to 25%). Results: A rise in plasma PC activity levels to within normal limits at 48h (P=0,01) and manteinment until 72h. Improving or even partial correction of hemostasis, and normalization of infectious parameters were assessed in all patients. No adverse effects were observed. One patient died. Discussions and conclusions: The administration of PC concentrate had a marked benefit on the deranged coagulation status of patients and revealed safe leading to a resolution of coagulation imbalance. These encouraging clinical and laboratory results and the absence of side effects warrant the initiation of a double blind randomized controlled multicenter trial.
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Decembrino, L., Stronati, M., Manzato, F. et al. 86 Protein C Concentrate for Sepsis-Induced Coagulopathy in Newborn. Pediatr Res 58, 369 (2005). https://doi.org/10.1203/00006450-200508000-00115
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DOI: https://doi.org/10.1203/00006450-200508000-00115