Abstract
Human protein C is a serine protease that circulates in the blood as an inactive zymogen. It is converted to its active form by interaction with thrombomodulin on the endothelial wall. Activated protein C has a significant role in maintaining haemostasis, and is a major mechanism of controlling microvascular thrombosis. Recent reports describe the use of drotrecogin alfa (recombinant activated protein C) in severe sepsis, a condition relevant to emergency medicine. This review describes the physiology of the protein C pathway and its importance in sepsis. It will also focus on the use of drotrecogin alfa in sepsis, and its use in the ED.
MeSH terms
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Adult
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Animals
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Anti-Infective Agents / adverse effects
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Anti-Infective Agents / economics
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Anti-Infective Agents / therapeutic use*
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Anti-Inflammatory Agents, Non-Steroidal / adverse effects
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Anti-Inflammatory Agents, Non-Steroidal / economics
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Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
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Child
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Drug Costs
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Emergency Medical Services / methods*
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Fibrinolytic Agents / adverse effects
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Fibrinolytic Agents / economics
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Fibrinolytic Agents / therapeutic use
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Hemorrhage / chemically induced
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Humans
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Patient Selection
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Protein C / adverse effects
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Protein C / economics
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Protein C / therapeutic use*
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Recombinant Proteins / adverse effects
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Recombinant Proteins / economics
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Recombinant Proteins / therapeutic use*
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Sepsis / drug therapy*
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Sepsis / physiopathology
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Treatment Outcome
Substances
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Anti-Infective Agents
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Anti-Inflammatory Agents, Non-Steroidal
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Fibrinolytic Agents
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Protein C
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Recombinant Proteins
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drotrecogin alfa activated