| Autor: |
Di Paolo, A, Cicchese, M, Fabiano, A |
| Zdroj: |
Pediatric Research; August 2005, Vol. 58 Issue: 2 p373-373, 1p |
| Abstrakt: |
The protein C pathway represents one of the major regulatory systems of hemostasis, exhibiting antithrombotic, anti-inflammatory, and profibrinolytic properties. Most cases of disseminated intravascular coagulation (DIC) and thrombosis are observed in neonatal bacterial sepsis. Many therapies are used in treatment of DIC with different results. In the last few years, a new therapy with extractive protein C (PC) to regulate the activated coagulation is available. The aim of our study is to verify the efficacy of PC infusion in patients with neonatal bacterial sepsis. The rationale of the study is to stop the intravascular coagulation and thrombosis using a natural regulator (PC) of the coagulation cascade.We performed a pilot study in a cohort of 12 preterm and term newborn infants with DIC secondary to severe bacterial sepsis and documented PC activity deficit due to the sepsis. We used PC intravenously once a day. Evaluating the PC deficit of activity and body weight we computed the dosage of PC to administer to infuse to each patient. To verify the efficacy of therapy we evaluated every day the PC activity, D-Dimer assay, PCR, WBC and platelet count.Two infants died (one had a severe prenatal brain haemorrhage; one had severe early onset sepsis and deceased in few hours). Ten children showed a rapid response to the therapeutic efforts and survived without any sequelae. We observed improved clinical conditions and raising in PC activity and D-Dimers reduction. No adverse reactions were observed during and after Ceprotin administration in all patients.The successful employment of PC would break new grounds in the neonatal sepsis treatment with DIC and/or thrombosis complications. These preliminary data should be confirmed by further clinical trials and promote controlled randomized double blind trial. |
| Databáze: |
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