Effect of recombinant thrombomodulin for DIC with septic shock

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  • Sato Eiichi
    Shinmatsudo Central General Hospital Department of Pathology, Dokkyo Medical University, Koshigaya Hospital
  • Matsumura Daisuke
    Shinmatsudo Central General Hospital
  • Nomura Mayumi
    Shinmatsudo Central General Hospital
  • Amaha Mayuko
    Shinmatsudo Central General Hospital
  • Ueda Yoshihiko
    Department of Pathology, Dokkyo Medical University, Koshigaya Hospital
  • Nakamura Tsukasa
    Shinmatsudo Central General Hospital Department of Pathology, Dokkyo Medical University, Koshigaya Hospital

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  • 敗血症性ショックに伴うDICに対するリコンビナントトロンボモジュリンの効果

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Abstract

<p>The efficacy of recombinant thrombomodulin (rTM) for treating disseminated intravascular coagulation (DIC)with septic shock has already been shown. However, adequate data on the action of rTM are not available. This retrospective study examined the sites of infection that rTM acted upon in treating septic DIC. The subjects were 19 septic DIC patients who were administered rTM and seen between July 2012 and July 2013. The evaluation items were SIRS, DIC, and SOFA scores. Also, subjects were divided into two groups: 10 patients treated with PMX-DHP and 9 not treated with PMX-DHP for whom the same evaluation items were investigated. The sites of infection were pneumonia 7, pyelonephritis 4, cellulitis 3, enterocolitis 3, catheter related infection 2, pleuritis 1, arthritis 1, cholangitis 1, discitis 1 (including overlapped). The mean initial dose was 7,009.0±2,680.7 U/day, mean days of administration were 5.9±2.1 days. The results before and after administration of rTM were: SIRS, from 2.95±0.91 to 0.68±1.06; DIC, from 4.21±1.96 to 2.35±1.54; SOFA, from 7.53±3.57 to 5.47±3.31. In SOFA score: respiratory, 1.32±1.38 to 0.68±1.25; coagulation, from 1.95±1.31 to 1.11±0.94; cardiovascular, from 1.42±1.64 to 0.68±1.29. All results were significant reductions. The 28-days survival rate of the PMX-DHP and non-PMX-DHP groups were 90.0% and 66.7% respectively, according to the Kaplan-Meier method. While there were only a small number of such cases, the results suggest administration of rTM protects organs from the effects of DIC. </p>

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