Plasma derived protein C in severe sepsis: report of two cases
Severe sepsis is defined as sepsis-associated organ dysfunction, (arterial hypoxemia, acute oliguria, coagulation abnormalities, thrombocytopenia, hyperbilirubinemia), hypoperfusion (hyperlactatemia) and arterial hypotension (mean arterial pressure <70 mmHg, or a systolic blood pressure decrease >40 mmHg) [3, 4]. Septic shock [3, 4] is defined as acute circulatory failure induced by sepsis with hypotension despite adequate fluid resuscitation.
A dysfunction of the protein C (PC) pathway is always present in severe sepsis and contributes to the development of coagulopathy and necrosis [12, 13]. This decrease is caused by consumption of protein C during systemic activation of blood coagulation and by reduced hepatic synthesis owing to septic liver dysfunction, but also by degradation of protein C by proteolytic enzymes, such as elastase, released by white blood cells .
Numerous studies have demonstrated that decreased circulating levels of protein C in septic patients are associated...
KeywordsSevere Sepsis Mean Arterial Pressure Teicoplanin Sofa Score Drotrecogin Alfa
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