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      What's new in Emergencies Trauma and Shock? C-reactive protein as a potential clinical biomarker for influenza infection: More questions than answers

      Journal of Emergencies, Trauma, and Shock

      Medknow Publications & Media Pvt Ltd

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          Most cited references 13

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          Acute-phase proteins and other systemic responses to inflammation.

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            Efficacy and safety of recombinant human activated protein C for severe sepsis.

            Drotrecogin alfa (activated), or recombinant human activated protein C, has antithrombotic, antiinflammatory, and profibrinolytic properties. In a previous study, drotrecogin alfa activated produced dose-dependent reductions in the levels of markers of coagulation and inflammation in patients with severe sepsis. In this phase 3 trial, we assessed whether treatment with drotrecogin alfa activated reduced the rate of death from any cause among patients with severe sepsis. We conducted a randomized, double-blind, placebo-controlled, multicenter trial. Patients with systemic inflammation and organ failure due to acute infection were enrolled and assigned to receive an intravenous infusion of either placebo or drotrecogin alfa activated (24 microg per kilogram of body weight per hour) for a total duration of 96 hours. The prospectively defined primary end point was death from any cause and was assessed 28 days after the start of the infusion. Patients were monitored for adverse events; changes in vital signs, laboratory variables, and the results of microbiologic cultures; and the development of neutralizing antibodies against activated protein C. A total of 1690 randomized patients were treated (840 in the placebo group and 850 in the drotrecogin alfa activated group). The mortality rate was 30.8 percent in the placebo group and 24.7 percent in the drotrecogin alfa activated group. On the basis of the prospectively defined primary analysis, treatment with drotrecogin alfa activated was associated with a reduction in the relative risk of death of 19.4 percent (95 percent confidence interval, 6.6 to 30.5) and an absolute reduction in the risk of death of 6.1 percent (P=0.005). The incidence of serious bleeding was higher in the drotrecogin alfa activated group than in the placebo group (3.5 percent vs. 2.0 percent, P=0.06). Treatment with drotrecogin alfa activated significantly reduces mortality in patients with severe sepsis and may be associated with an increased risk of bleeding.
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              C-reactive protein: a critical update.

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                Author and article information

                Affiliations
                c/o Emergency Medicine Department, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Malaysia
                Author notes
                Address for correspondence: Dr. Keng Sheng Chew, E-mail: cksheng74@ 123456yahoo.com
                Journal
                J Emerg Trauma Shock
                J Emerg Trauma Shock
                JETS
                Journal of Emergencies, Trauma, and Shock
                Medknow Publications & Media Pvt Ltd (India )
                0974-2700
                0974-519X
                Apr-Jun 2012
                : 5
                : 2
                : 115-117
                3391832
                22787338
                JETS-5-115
                10.4103/0974-2700.96477
                Copyright: © Journal of Emergencies, Trauma, and Shock

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Editorial

                Emergency medicine & Trauma

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