tailieunhanh - Báo cáo y học: " Activated protein C in septic shock: a propensity-matched analysis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Activated protein C in septic shock: a propensity-matched analysis. | Sadaka et al. Critical Care 2011 15 R89 http content 15 2 R89 KS CRITICAL CARE RESEARCH Open Access Activated protein C in septic shock a propensity-matched analysis Farid Sadaka Jacklyn O Brien Matthew Migneron Julie Stortz Alexander Vanston Robert W Taylor Abstract Introduction The use of human recombinant activated protein C rhAPC for the treatment of severe sepsis remains controversial despite multiple reported trials. The efficacy of rhAPC remains a matter of dispute. We hypothesized that patients with septic shock who were treated with rhAPC had an improved in-hospital mortality compared to patients with septic shock with similar acuity who did not receive rhAPC. Methods This retrospective cohort study was completed at a large university-affiliated hospital. All patients with septic shock admitted to a 50-bed ICU between July 2003 and February 2009 were included. Patients were treated according to sepsis management guidelines. Results A total of 563 septic shock patients were included 110 received rhAPC and 453 did not . Treated and untreated groups were matched in patient characteristics comorbidities and physiologic variables in a 1 1 propensity-matched analysis 108 received rhAPC 108 did not . Mean Acute Physiology And Chronic Health Evaluation II APACHE II scores were for the matched treated and for the matched untreated group P . Receipt of rhAPC was associated with reduced in-hospital mortality vs. P similar mean days on vasopressors 2 vs. 2 P similar mean days on mechanical ventilation 9 vs. P similar mean length of ICU stay in days vs. P and similar mean length of hospital stay in days vs 27 P . No patients in either group had intracranial bleeding differences in gastrointestinal bleeding and transfusion requirements were not statistically significant. Conclusions Patients in our institution with septic shock who were treated with rhAPC had a reduced in-hospital .