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Critical Care
Published in: Critical Care 1/2008

01-02-2008 | Letter

Increased bleeding risk associated with the use of recombinant human activated protein C in patients with advanced liver disease

Authors: Adam Keene, Thomas Kawano, Syed Anees, Julie Chen

Published in: Critical Care | Issue 1/2008

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Excerpt

Advanced liver disease (ALD) was an exclusion criteria from enrollment in the major clinical trials of recombinant human activated protein C (APC), but is listed on the package insert as a relative contraindication rather than an absolute contra-indication to APC administration [1]. There are recent reports of elevated rates of bleeding due to APC in clinical practice, particularly in patients with relative contraindications to the drug [2, 3]. Since many patients who develop septic shock at Montefiore Medical Center in the Bronx, New York have ALD, we decided to evaluate whether such patients have an increased risk for bleeding during APC administration. …
Literature
1.
Bernard GR, VIncent JL, Laterre PF, LaRosa SP, Dhainaut JF, Lopez-Rodriguez A, Steingrub JS, Garber GE, Helterbrand JD, ELY EW, et al.: Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 2001, 344: 699-709. 10.1056/NEJM200103083441001CrossRefPubMed
2.
Kanji S, Perreault MM, Chant C, Williamson D, Burry L: Evaluating the use of Drotrecogin alfa (activated) in adult severe sepsis. Intensive Care Med 2007, 33: 517-523. 10.1007/s00134-007-0555-9CrossRefPubMed
3.
Bertolini G, Rossi C, Anghileri A, Livigni S, Addis A, Poole D: Use of drotrecogin alfa (activated) in Italian intensive care units. Intensive Care Med 2007, 33: 426-434. 10.1007/s00134-007-0554-xCrossRefPubMed
Metadata
Title
Increased bleeding risk associated with the use of recombinant human activated protein C in patients with advanced liver disease
Authors
Adam Keene
Thomas Kawano
Syed Anees
Julie Chen
Publication date
01-02-2008
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2008
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc6774

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