Efficacy and Safety of Recombinant Human Activated Protein C for Severe Sepsis

Severe sepsis, defined as sepsis associated with acute organ dysfunction, results from a generalized inflammatory and procoagulant response to an infection. 1 The rate of death from severe sepsis ranges from 30 to 50 percent despite advances in critical care. 2 – 5 In the United States, approximately 750,000 cases of sepsis occur each year, at least 225,000 of which are fatal. 6 The inflammatory and procoagulant host responses to infection are closely related. 7 Inflammatory cytokines, including tumor necrosis factor α, interleukin-1β, and interleukin-6, are capable of activating coagulation and inhibiting fibrinolysis, whereas the procoagulant thrombin is capable of stimulating multiple inflammatory pathways. 7 – . . .