Saturday November 19, 2005
Drotrecogin Alfa (Activated) tie to APACHE Score

Drotrecogin Alfa (Activated) - Xigris - is without doubt an effective tool in treating sepsis but there are debates about "to do or not to do".

Irrespective of reservations regarding APACHE II score itself, it is important to know the results of study from ADDRESS Study Group (Administration of Drotrecogin Alfa (Activated) in Early Stage Severe Sepsis), which concluded that it should not be use in patients with APACHE II score less than 25. There was extra risk of bleeding without any benefit. Actually subset of same study found to have higher mortality (both 28-days and inpatient) in those patients who underwent recent surgery (within 30 days) and had only single organ failure - irrespective of APACHE score. There were significantly more bleeding events in the Xigris group.

See APACHE Scorings in our tools section at www.icuroom.net.

References: click to get abstract/article
1. Drotrecogin Alfa (Activated) for Adults with Severe Sepsis and a Low Risk of Death - NEJM - Volume 353:1332-1341 - september 29, 2005.
2. Warning from Xigris