Recombinant human activated protein C in acute lung injury: what is the role of bronchial circulation?
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* Corresponding author: Daniel L Traber dltraber@utmb.edu
Department of Anesthesiology, The University of Texas Medical Branch and Shriners Burns Hospital at Galveston, 601 Harborside Drive, Galveston, TX 77555-1102, USA
Critical Care 2009, 13:112 doi:10.1186/cc7155
Published: 23 January 2009Abstract
Impairment of the protein C pathway plays a central role in the pathogenesis of sepsis. Treatment with recombinant human activated protein C (rhAPC) has been reported to increase survival from severe sepsis. Protein C levels also decrease markedly in acute lung injury, of both septic and nonseptic origin. Low levels of protein C in acute lung injury are associated with poor clinical outcome. The present article discusses the beneficial effects of rhAPC in oleic acid-induced lung injury as well as the controversies between different animal models and the timing of drug administration. The unique bronchial circulation in ovine models seems to be responsible for the beneficial effects of rhAPC when given simultaneously to the injury.