THROMBOMODULIN ALFA IN THE TREATMENT OF INFECTIOUS PATIENTS COMPLICATED BY DISSEMINATED INTRAVASCULAR COAGULATION
- 1 April 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Shock
- Vol. 35 (4), 349-354
- https://doi.org/10.1097/shk.0b013e318204c019
Abstract
To investigate treatment effects of thrombomodulin alfa (TM-α) in patients with disseminated intravascular coagulation (DIC) having infection as the underlying disease, retrospective subanalysis of a double-blind, randomized controlled phase 3 trial was conducted. In the phase 3 trial, 227 DIC patients (full-analysis set) having infection and/or hematologic malignancy as the underlying disease received either TM-α (0.06 mg·kg for 30 min once daily) or heparin (8 U·kg·h for 24 h) for 6 days using the double-dummy method. Among these patients, 147 patients with noninfectious comorbidity leading to severe thrombocytopenia (e.g., hematologic malignancy, or aplastic anemia) were excluded from the present analysis, and 80 patients with infectious disease and DIC were extracted and subjected to the present retrospective subanalysis. Disseminated intravascular coagulation resolution rates were determined using the DIC diagnostic criteria for critically ill patients at 7 days, and mortality rates were evaluated at 28 days. In the TM-α and heparin groups, DIC resolution rates were 67.5% (27/40) and 55.6% (20/36), and 28-day mortality rates were 21.4% (9/42) and 31.6% (12/38), respectively. Mortality rates of patients who recovered from DIC were 3.7% (1/27) in the TM-α group and 15% (3/20) in the heparin group. These results suggest TM-α may be valuable in the treatment of DIC associated with infection.Keywords
This publication has 32 references indexed in Scilit:
- SIRS-ASSOCIATED COAGULOPATHY AND ORGAN DYSFUNCTION IN CRITICALLY ILL PATIENTS WITH THROMBOCYTOPENIAShock, 2007
- Does Disseminated Intravascular Coagulation Lead to Multiple Organ Failure?Critical Care Clinics, 2005
- Dynamic evolution of coagulopathy in the first day of severe sepsis: Relationship with mortality and organ failure*Critical Care Medicine, 2005
- Prospective validation of the International Society of Thrombosis and Haemostasis scoring system for disseminated intravascular coagulation*Critical Care Medicine, 2004
- Treatment effects of drotrecogin alfa (activated) in patients with severe sepsis with or without overt disseminated intravascular coagulationJournal of Thrombosis and Haemostasis, 2004
- Coagulation/fibrinolysis abnormality and vascular endothelial damage in the pathogenesis of thrombocytopenic multiple organ failureCritical Care Medicine, 2002
- High-Dose Antithrombin III in Severe SepsisJAMA, 2001
- An enhanced fibrinolysis prevents the development of multiple organ failure in disseminated intravascular coagulation in spite of much activation of blood coagulationCritical Care Medicine, 2001
- Efficacy and Safety of Recombinant Human Activated Protein C for Severe SepsisThe New England Journal of Medicine, 2001
- Disseminated Intravascular CoagulationThe New England Journal of Medicine, 1999