Table 2

Drotrecogin alfa (activated) infusion interruptions during procedures: recommended actions

Procedure
Action

Minor procedures

Arterial line insertion (radial or femoral)
Hold infusion for 2 hours before procedure and restart immediately after, in the absence of bleeding
Venous femoral line insertion

Intubation or tracheostomy change (unless urgent)

More invasive procedures

Central line or Swan-Ganz insertion (subclavian or jugular)
Hold infusion for 2 hours before and restart 2 hours after, in the absence of bleeding
Lumbar puncture

Chest tube insertion or thoracocentesis

Paracentesis

Percutaneous drainage

Nephrostomy

Gastroscopy (possible biopsy)

Wound debridment (decubitus ulcer, infected wound, packing changes in open abdomen, etc.)

Major procedures

Surgery (laparotomy, thoracotomy, major debridment, etc.)
Hold infusion for 2 hours and wait for 12 hours before restarting infusion
Epidural catheter
For epidural catheter, do not use drotrecogin or wait for 12 hours after removal before starting drug infusion

Adapted from Taylor and coworkers [19].

Laterre and Wittebole Critical Care 2003 7:445   doi:10.1186/cc2342