Recombinant human activated protein C in acute lung injury: what is the role of bronchial circulation?

doi:10.1186/cc7155

Critical Care
Volume 13
Issue 1

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Recombinant human activated protein C in acute lung injury: what is the role of bronchial circulation?

Marc O Maybauer, Daniel L Traber and Dirk M Maybauer

Department of Anesthesiology, The University of Texas Medical Branch and Shriners Burns Hospital at Galveston, 601 Harborside Drive, Galveston, TX 77555-1102, USA

author email corresponding author email

Critical Care 2009, 13:112doi:10.1186/cc7155


Published:	23 January 2009

See related research by Waerhaug et al., http://ccforum.com/content/12/6/R146

Abstract

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.