Protein C for sepsis and fulminant purpura – pro

Protein C Concentrate (Human) is used for patients with severe congenital Protein C deficiency for the prevention and treatment of venous thrombosis (blood clot in the vein), and purpura fulminans (blood spots, bruising and discoloring to skin as a result of clotting of small blood vessels in the skin). CEPROTIN is indicated as a replacement therapy for pediatric and adult patients.

There some preliminary support that Ceptrotin may be useful in prupura fulminans adn sepsis. In these conditions, Protein C levels go down adn there may be a benefit to restoring them by inhusing Protein C concentrate. Only retrospective reviews and case series are currently available in the literatureadn there is a general agreement that prospective studies are warranted. A Surviving Sepsis Guideline does recommend a recombinant activated protein C in patients with severe sepsis and clinical assessment of high risk for death (2B except 2C for postoperative patients). No such guideline si availalbe for purpura fulmonans, to my knowledge.

Ceprotin, Prescribing information

Schellongowski, Peter; Bauer, Edith; Holzinger, Ulrike; Staudinger, Thomas; Frass, Michael; Laczika, Klaus; Locker, Gottfried J; Quehenberger, Peter; Rabitsch, Werner; Schenk, Peter; Knöbl, Paul; Treatment of adult patients with sepsis-induced coagulopathy and purpura fulminans using a plasma-derived protein C concentrate (Ceprotin).VOX SANGUINIS Vol. 90 Issue 4 May 2006

Veldman A, Fischer D, Wong FY, Kreuz W, Sasse M, Eberspächer B, Mansmann U, Schosser R.
Human protein C concentrate in the treatment of purpura fulminans: a retrospective analysis of safety and outcome in 94 pediatric patients.Crit Care. 2010;14(4):R156.

Bruley, Duane Frederick; Zymogen protein C concentrate for safer heterozygote surgery, “I am a guinea pig” ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY Vol. 645 2009

Baratto, Fabio; Michielan, Flavio; Meroni, Muzio; Dal Palù, Antonella; Boscolo, Annalisa; Ori, Carlo; Protein C concentrate to restore physiological values in adult septic patients. INTENSIVE CARE MEDICINE Vol. 34 Issue 9 Sep 2008

A. Puxty et al, Recombinant activated protein C usage in Scotland: a comparison with published guidelines and a survey of attitudes†
Anaesthesia Volume 67, Issue 1, pages 43–50, January 2012

Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL; International Surviving Sepsis Campaign Guidelines Committee; American Association of Critical-Care Nurses; American College of Chest Physicians; American College of Emergency Physicians; Canadian Critical Care Society; European Society of Clinical Microbiology and Infectious Diseases; European Society of Intensive Care Medicine; European Respiratory Society; International Sepsis Forum; Japanese Association for Acute Medicine; Japanese Society of Intensive Care Medicine; Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008.Crit Care Med. 2008 Jan;36(1):296-327.

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