ArticleBMC anesthesiology2013
The aPC treatment improves microcirculation in severe sepsis/septic shock syndrome.
Article in BMC anesthesiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01806428 (THE Activated Protein C), which is not on this map. Cited by 22 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
THE Activated Protein C (aPC) TREATMENT IMPROVES MICROCIRCULATION IN SEVERE SEPSIS/ SEPTIC SHOCK SYNDROME
Who cites it
22 citing papers in PubMed, 44 citations in OpenAlex.
- Effect of high-dose intravenous ascorbic acid on microcirculation and endothelial glycocalyx during sepsis and septic shock: a double-blind, randomized, placebo-controlled study.BMC anesthesiology · 2023Trial
- Plasma free hemoglobin and microcirculatory response to fresh or old blood transfusions in sepsis.PloS one · 2015Trial
- Effects of Endotoxemia and Blood Pressure on Microcirculation and Noradrenaline Needs With or Without Dexmedetomidine in Beagle Dogs-A Blinded Cross-Over Study.Animals : an open access journal from MDPI · 2025Article
- The future of intensive care: the study of the microcirculation will help to guide our therapies.Critical care (London, England) · 2023Review
- Nanodrugs alleviate acute kidney injury: Manipulate RONS at kidney.Bioactive materials · 2023Review
- Microcirculation-guided resuscitation in sepsis: the next frontier?Frontiers in medicine · 2023Review
- Identification of novel sublingual parameters to analyze and diagnose microvascular dysfunction in sepsis: the NOSTRADAMUS study.Critical care (London, England) · 2021Observational
- Risk of chronic kidney disease in patients with heat injury: A nationwide longitudinal cohort study in Taiwan.PloS one · 2020Article
- IgM-enriched immunoglobulins (Pentaglobin) may improve the microcirculation in sepsis: a pilot randomized trial.Annals of intensive care · 2019Article
- Association of sublingual microcirculation parameters and endothelial glycocalyx dimensions in resuscitated sepsis.Critical care (London, England) · 2019Observational
- Opportunities for Host-targeted Therapies for Malaria.Trends in parasitology · 2018Review
- Role of Combining Peripheral with Sublingual Perfusion on Evaluating Microcirculation and Predicting Prognosis in Patients with Septic Shock.Chinese medical journal · 2018Article
- Paradigms of acute kidney injury in the intensive care setting.Nature reviews. Nephrology · 2018Review
- An ADAM-10 dependent EPCR shedding links meningococcal interaction with endothelial cells to purpura fulminans.PLoS pathogens · 2018Article
- Bedside analysis of the sublingual microvascular glycocalyx in the emergency room and intensive care unit - the GlycoNurse study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Observational
- Impact of microcirculatory video quality on the evaluation of sublingual microcirculation in critically ill patients.Journal of clinical monitoring and computing · 2017Article
- Effects of short-term hyperoxia on erythropoietin levels and microcirculation in critically Ill patients: a prospective observational pilot study.BMC anesthesiology · 2017Observational
- THE ENDOTHELIUM IN SEPSIS.Shock (Augusta, Ga.) · 2016Review
- Microcirculatory dysfunction and tissue oxygenation in critical illness.Acta anaesthesiologica Scandinavica · 2015Review
- Causes and consequences of coagulation activation in sepsis: an evolutionary medicine perspective.BMC medicine · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe role of recombinant activated protein C (aPC) during sepsis is still controversial. It showed anti-inflammatory effect and improved the microvascular perfusion in experimental models of septic shock. The present study was aimed at testing the hypothesis that recombinant aPC therapy improves the microcirculation during severe sepsis.
methodsProspective observational study on patients admitted in a 12-beds intensive care unit of a university hospital from July 2010 to December 2011, with severe sepsis and at least two sepsis-induced organ failures occurring within 48 hours from the onset of sepsis, who received an infusion of aPC (24 mcg/kg/h for 96 hours) (aPC group). Patients with contraindications to aPC administration were also monitored (no-aPC group).At baseline (before starting aPC infusion, T0), after 24 hours (T1a), 48 hours (T1b), 72 hours (T1c) and 6 hours after the end of aPC infusion (T2), general clinical and hemodynamic parameters were collected and the sublingual microcirculation was evaluated with sidestream dark-field imaging. Total vessel density (TVD), perfused vessel density (PVD), De Backer score, microvascular flow index (MFIs), the proportion of perfused vessels (PPV) and the flow heterogeneity index (HI) were calculated for small vessels. The perfused boundary region (PBR) was measured as an index of glycocalyx damage. Variables were compared between time points and groups using non parametric or parametric statistical tests, as appropriate.
resultsIn the 13 aPC patients mean arterial pressure (MAP), base excess, lactate, PaO2/FiO2 and the Sequential Organ Failure Assessment (SOFA) score significantly improved over time, while CI and ITBVI did not change. MFIs, TVD, PVD, PPV significantly increased over time and the HI decreased (p < 0.05 in all cases), while the PBR did not change. No-aPC patients (n = 9) did not show any change in the microcirculation over time. A positive correlation was found between MFIs and MAP. TVD, PVD and De Backer score negatively correlated with norepinephrine dose, and the SOFA score negatively correlated with MFIs, TVD and PVD.
conclusionsaPC significantly improves the microcirculation in patients with severe sepsis/septic shock.
trial registrationNCT01806428.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.