22 May 2003
Use of drotrecorgin alfa – recombinant activated human protein C in treatment of septic shock in the course of therapy for nephrolithiasis
Jadwiga Biernacka, Jarosław Wośko, Wojciech Dąbrowski, Andrzej NestorowiczMed Sci Monit 2003; 9(5): CS25-28 :: ID: 11079
Abstract
Background: Septic shock is the most dangerous complication of nephrolithiasis management utilizing percutaneous methods.
Case report: The patient, D.M., aged 60 was subjected to scheduled percutaneous nephrolithotomy due to coral calculosis of the pyelocalyceal system. As pyuria was noted intraoperatively, nephrostomy was left after the procedure. Over ten hours after the surgery the patient developed the symptoms of severe septic shock with progressive respiratory distress, renal failure, intravascular
coagulation syndrome and impaired consciousness. Nephrectomy was performed, antibiotic treatment and high doses of norepinephrine instituted. Hemodynamic stabilization was obtained, without, however, marked improvement of the patient’s condition. Because of
persistent coagulation disorders and multiorgan dysfunction, recombinant activated protein C preparation – drotrecorgin alfa (Xigris Eli Lilly) was added to the therapeutic regimen. From
the second day of infusion, systematic improvement of the coagulation system parameters was observed, making it possible to reduce the doses of catecholamines, oxygen concentration in
the gas mixture used for ventilation, as well as stabilization of the function of the preserved kidney. The patient was weaned off the respirator on the 8th day of treatment and on the 13th
day referred to the Urology Department, from which she was soon discharged home.
Conclusions: 1. Surgical resection of the infection source and cause of the septic shock is the prerequisite for successful pharmacological treatment.
2. Administration of rh-APC to a patient meeting the PROWESS criteria may be an effective and safe method of treatment in the complex management of septic shock.
Keywords: Disseminated Intravascular Coagulation - blood, Disseminated Intravascular Coagulation - drug therapy, Disseminated Intravascular Coagulation - etiology, Kidney Calculi - complications, Kidney Calculi - therapy, Nephrectomy, Nephrostomy, Percutaneous - adverse effects, Protein C - therapeutic use, Recombinant Proteins - therapeutic use, Shock, Septic - blood, Shock, Septic - drug therapy, Shock, Septic - etiology, Staphylococcal Infections - blood, Staphylococcal Infections - drug therapy, Staphylococcal Infections - etiology, Staphylococcus haemolyticus
Editorial
04 June 2022 : Editorial
Editorial: Acute Hepatitis of Unknown Origin in Children. Is Autoimmunity at Play?DOI: 10.12659/MSM.937371
Med Sci Monit 2022; 28:e937371
SARS-CoV-2/COVID-19
27 June 2022 : Clinical Research
Shoulder Injury Related to Vaccine Administration (SIRVA) in 16 Patients Following COVID-19 Vaccination Who...Med Sci Monit In Press; DOI: 10.12659/MSM.937430
04 June 2022 : Clinical Research
Screening for SARS-CoV-2 Infection in Students at the Medical University of Warsaw, Poland Between November...Med Sci Monit 2022; 28:e936962
30 May 2022 : Clinical Research
Effects of Wearing Face Masks on Exercise Capacity and Ventilatory Anaerobic Threshold in Healthy Subjects ...Med Sci Monit 2022; 28:e936069
27 May 2022 : Clinical Research
Factors Associated with Falls During Hospitalization for Coronavirus Disease 2019 (COVID-19)Med Sci Monit 2022; 28:e936547
In Press
30 Jun 2022 : Clinical Research
Antioxidant System and Ions Concentrations After Femoral Neck and Resurfacing Hip ArthroplastyMed Sci Monit In Press; DOI: 10.12659/MSM.936335
28 Jun 2022 : Meta-Analysis
Urodynamics in Early Diagnosis of Diabetic Bladder Dysfunction in Women: A Systematic Review and Meta-AnalysisMed Sci Monit In Press; DOI: 10.12659/MSM.937166
28 Jun 2022 : Clinical Research
Serum Calprotectin – a NET Product – as a Biomarker of Disease Activity in Patients with Systemic Lupus Ery...Med Sci Monit In Press; DOI: 10.12659/MSM.936534
28 Jun 2022 : Database Analysis
LINC00963 May Be Associated with a Poor Prognosis in Patients with Cervical CancerMed Sci Monit In Press; DOI: 10.12659/MSM.935070
Most Viewed Current Articles
30 Dec 2021 : Clinical Research
Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...DOI :10.12659/MSM.935379
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review article
A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...DOI :10.12659/MSM.936292
Med Sci Monit 2022; 28:e936292
01 Nov 2020 : Review article
Long-Term Respiratory and Neurological Sequelae of COVID-19DOI :10.12659/MSM.928996
Med Sci Monit 2020; 26:e928996
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952