Logo Medical Science Monitor

Call: +1.631.470.9640
Closed: National Holiday

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

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 Nestorowicz

Med Sci Monit 2003; 9(5): CS25-28 :: ID: 11079


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

Add Comment 0 Comments

594 0


01 May 2023 : Editorial  

Editorial: Twenty Years On from Sequencing the Human Genome, Personalized/Precision Oncology Prepares to Meet the Challenges of Checkpoint Inhibitor Therapy

Dinah V. Parums
Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

DOI: 10.12659/MSM.940911

Med Sci Monit 2023; 29:e940911

In Press

28 May 2023 : Database Analysis  

Scientometric and Visualized Analysis of Intravoxel Incoherent Motion Magnetic Resonance Imaging: 1988-2021

Med Sci Monit In Press; DOI: 10.12659/MSM.938715  

25 May 2023 : Database Analysis  

The COVID-19 Crisis and the Incidence of Alcohol-Related Deaths in Poland

Med Sci Monit In Press; DOI: 10.12659/MSM.940904  

25 May 2023 : Review article  

A Review of Preclinical and Clinical Studies in Support of the Role of Non-Steroidal Anti-Inflammatory Drug...

Med Sci Monit In Press; DOI: 10.12659/MSM.940635  

25 May 2023 : Clinical Research  

Periapical Lesions and Missed Canals in Endodontically Treated Teeth: A Cone-Beam Computed Tomographic Stud...

Med Sci Monit In Press; DOI: 10.12659/MSM.940533  

Most Viewed Current Articles

13 Nov 2021 : Clinical Research  

Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...

DOI :10.12659/MSM.932788

Med Sci Monit 2021; 27:e932788

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 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

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750