• A Maurice, P Seguin, D Aguillon, C Chanavaz, and Y Mallédant.
• Service de réanimation chirurgicale, CHU Pontchaillou, 2, rue Henri-Le-Guillou, 35033 Rennes cedex 09, France. axelle.maurice@chu-rennes.fr
• Ann Fr Anesth Reanim. 2005 Apr 1;24(4):343-6.

ObjectiveTo evaluate the use of activated C protein (ACP) in a Surgical Intensive Care Unit.Study DesignA prospective observational study.Patients And MethodsAll patients receiving ACP during 20 months in the operative period.ResultsTwenty-three patients were treated by ACP. The origin of sepsis was peritonitis (n = 14), infected pancreatitis (n = 3), mediastinitis (n = 2), one urologic sepsis, one facial cellulitis, one catheter related infection, and one postoperative pneumonia. In two cases, the peritonitis was associated with a pleuretic infection, and in two other cases with parietal cellulites. Mean age was 69+/-13 years. Severities evaluated by SAPS II, LODS were 59+/-13 and 7+/-3, respectively. Mean number organ dysfunction was 3.3+/-1.0. Septic shock was present in 91% with concomitant use of catecholamines for a mean period of 87+/-64 hours. Bacteraemia was present in 43% of the patients. A treatment with hydrocortisone was associated in 52% of the patients. The ICU and hospital lengths of stay were 15+/-16 days, and 34+/-38 days, respectively. Mortality at day 28 was 35%. Two significant bleeding were observed, one requiring red blood cell transfusion and the other one a surgical control of the bleeding associated with red blood cell transfusion.ConclusionWith global management of severe sepsis, including the use of activated C Protein, this prospective observational study showed a 30% reduction of the predicted mortality by SAPS II scoring without significant increase of bleeding episodes in a surgical context.

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