Does Xigris help in ALI ? - 2
I saw your pearl from yesterday "Does Xigris help in ALI" and recalled seeing following article, which has yet to publish. It might make a good counterpoint.
Tony Halat, MD
Clinical Instructor in Medicine
Department of Medicine, The Methodist Hospital
Weill Medical College, Cornell University
Randomized Clinical Trial of Activated Protein C for the Treatment of ALI
Objective: To test the efficacy of activated protein C as a therapy for patients with acute lung injury.
Methods: Eligible subjects were critically ill patients who met the American/European consensus criteria for acute lung injury. Patients with severe sepsis and an APACHE II score 25 were excluded. Participants were randomized to receive activated protein C (24 mcg/kg/hour for 96 hours) or placebo in a double-blind fashion within 72 hours of the onset of acute lung injury.
The primary endpoint was ventilator free days.
Measurements and Main Results:
- Activated protein C increased plasma protein C levels (p=0.002) and decreased pulmonary dead space fraction (p=0.02).
- However, there was no statistically significant difference between patients receiving placebo (n=38) or activated protein C (n=37) in the number of ventilator free days or in 60-day mortality.
- There were no differences in the number of bleeding events between the two groups.
Conclusions: Activated protein C did not improve outcomes from acute lung injury. The results of this trial do not support a large clinical trial of activated protein C for acute lung injury in the absence of severe sepsis and high disease severity.
Reference: Click to get article
Randomized Clinical Trial of Activated Protein C for the Treatment of Acute Lung Injury - Published ahead of print on June 19, 2008 Am. J. Respir. Crit. Care Med. 2008
