全身炎症反应综合症与脓毒血症下(编辑修改稿)

全身炎症反应综合症与脓毒血症下(编辑修改稿)内容摘要：

20xx Drotrecogin alfa (activated) (rhAPC) in Severe Sepsis Rebinant Human Activated Protein C  Remended in adult pts with sepsisinduced an dysfunction associated with a high risk of death (APACHE II 25) or multiple an failure and with no contraindications related to bleeding Grade 2B  Adult patients with severe sepsis and low risk of death (APACHE II 20) or one an failure should not receive rhAPC Grade 1A PROWESS Study Design  Randomized, doubleblind, placebocontrolled trial of drotrecogin alfa (activated)  164 sites in 11 countries  1690 patients (age 1896 years) Population—Severe Sepsis  Presence of a known or suspected infection  Evidence of a systemic response to the infection (3 or more SIRS criteria)  At least one sepsisassociated an dysfunction of no longer than 24 hours duration Treatment Arms  All patients received conventional care (1:1 randomization)  1:1 randomization to drotrecogin alfa (activated) 24 181。 g/kg/hr or placebo for 96 hours Bernard GR, et al. N Engl J Med 20xx。 344:699709 Bernard GR, et al. N Engl J Med 20xx。 344:699709 0 7 14 21 28 70 80 90 100 Days from Start of Infusion to Death Percent Survivors P=.006 (stratified logrank test) 0 Placebo (n=840) Drotrecogin alfa (activated) (n=850) Drotrecogin Alfa (Activated) Significantly Reduced Mortality in PROWESS 6% Absolute mortality difference Administration of DrotAA in Early Stage Severe Sepsis (ADDRESS)  International, randomized, placebocontrolled study to evaluate the efficacy of DrotAA for adults with severe sepsis and low risk of death • APACHE II 25 or singlean failure  N=2640 patients  Trial terminated early because of a projected lack of effect Abraham E, et al. NEJM 20xx。 353:133241。