Simultaneous use of continuous veno-venous hemodiafiltration and activated protein C for treatment of septic shock and acute renal failure (case report)
Küçük Resim Yok
Tarih
2006
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Objective: The mortality of severe sepsis and septic shock is extremely high. We aimed to present a case to which we applicated continuous veno-venous hemodiafiltration and activated protein C for treatment of septic shock and acute renal failure. Case report: Assessment of the 42 -year old male with gun-shot wound in the emergency service revealed that Glasgow Coma Scale 3, isochoric pupils, bilateral positive light reflex, cold and pale skin, spontaneous ventilation rate (38 min-1), blood pressure (64/42 mmHg), and heart rate (174 min-1). In urgent operation, primary repair of liver laceration and diaphragm rupture, cholecystectomy, caecum resection and ileocolostomy, greft to femoral artery, thorax drainage with bilateral tubes, orchiectomy and debridment of tibia fracture were performed. After the operation, he was mechanically ventilated in intensive care unit. In first day, APACHE II score was determined as 34. In the 9th day, septic shock and acute renal failure developed in spite of antibacterial and supportive treatments. In another operation, subhepatic abscess drainage, repair of ileocolic anastomosis and ileostomy were performed. Activated protein C and continuous veno-venous hemodiafiltration were started following the operation. Activated protein C treatment was stopped for 2 hours and than percutaneous tracheotomy was performed. Activated protein C was started again one hour after the tracheotomy and than administered totally 96 hours. Patient was discharged with tibia fracture sequel in the 47th day. Conclusion: In a case with septic shock and acute renal failure due to abdominal infection, in addition to standard care and treatment of cause of sepsis, simultaneous continuous veno-venous hemodiafiltration application and activated protein C administration may be life-saving.
Açıklama
Anahtar Kelimeler
Activated protein C, Acute renal failure, Continuous veno-venous hemodiafiltration, Septic shock
Kaynak
Anestezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Q4
Cilt
14
Sayı
2
