tailieunhanh - Báo cáo y học: "Endogenous plasma activated protein C levels and the effect of enoxaparin and drotrecogin alfa (activated) on markers of coagulation activation and fibrinolysis in pulmonary embolism."

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: Endogenous plasma activated protein C levels and the effect of enoxaparin and drotrecogin alfa (activated) on markers of coagulation activation and fibrinolysis in pulmonary embolism. | Dempfle et al. Critical Care 2011 15 R23 http content 15 1 R23 KS CRITICAL CARE RESEARCH Open Access Endogenous plasma activated protein C levels and the effect of enoxaparin and drotrecogin alfa activated on markers of coagulation activation and fibrinolysis in pulmonary embolism 1 1 2 1 1 3 Carl-Erik H Dempfle Elif Elmas Andreas Link Nenad Suvajac Volker Liebe Jonathan Janes Martin Borggrefe 1 Abstract Introduction There are no published data on the status of endogenous activated protein C APC in pulmonary embolism PE and no data on the effect of drotrecogin alfa activated DAA given in addition to therapeutic dose enoxaparin. Methods In this double-blind clinical trial 47 patients with computed tomography CT -confirmed acute submassive PE treated with 1 mg kg body weight of enoxaparin twice daily were randomized to groups receiving a 12-hour intravenous infusion of 6 12 18 or 24 pg kg hour of DAA or a placebo. Blood samples were drawn before starting DAA infusion after 4 8 and 12 hours at the end of the infusion period and on treatment days 2 3 4 5 and 6. Results Initial endogenous plasma activated protein C APC levels were ng ml to ng ml and remained in the same range in the placebo group. APC levels in patients treated with DAA were ng ml ng ml ng ml and ng ml in patients treated with 6 12 18 and 24 pg kg hour DAA respectively. In patients with a D-dimer level 4 mg L indicating a high level of acute fibrin formation and dissolution DAA infusion resulted in a more rapid drop in soluble fibrin D-dimer and fibrinogen fibrin degradation products FDP levels compared to enoxaparin alone. There was a parallel decline of soluble fibrin D-dimer FDP and plasmin-plasmin inhibitor complex PPIC in response to treatment with enoxaparin DAA with no evidence of a systemic profibrinolytic effect of the treatment. Conclusions In patients with acute submassive PE endogenous APC levels are low. DAA .

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