Protein C zymogen in adults with severe sepsis or septic shock

Abstract Introduction Activated protein C is associated with a risk of bleeding and its effects on survival in septic shock patients are questionable. Protein C zymogen has no risk of bleeding and improves the outcome of patients with septic shock. We hereby describe the largest published case series of adult patients receiving protein C zymogen. Design, setting and participants A prospective study on 23 adult patients with severe sepsis or septic shock, two or more organ failures and at high risk for bleeding, treated with protein C zymogen (50 IU/kg bolus followed by continuous infusion of 3 IU/kg/h for 72 h). Results The Z -test evidenced a significant reduction between the expected mortality (53%) and the observed mortality 30% ( Z value = 1.99, p  = 0.046) in our sample population. Protein C levels increased from 34 ± 18% to 66 ± 22% at 6 h after PC bolus ( p p p Conclusion Protein C zymogen administration is safe and its use in septic patients should be investigated through a randomized controlled trial.