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• W2066125069 abstract "Simon Nadel and colleagues, in their randomised trial on drotrecogin alfa in children with severe sepsis (March 10, p 836),1Nadel S Goldstein B Williams MD et al.for the REsearching severe Sepsis and Organ dysfunction in children: a gLobal perspective (RESOLVE) study groupDrotrecogin alfa (activated) in children with severe sepsis: a multicentre phase III randomised controlled trial.Lancet. 2007; 369: 836-843Summary Full Text Full Text PDF PubMed Scopus (414) Google Scholar do not mention heparin. Treatment with heparins was a consistent confounder in three large trials of anticoagulant proteins for sepsis.2Bernard GR Vincent JL Laterre PF et al.for the Recombinant human protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study groupEfficacy and safety of recombinant human activated protein C for severe sepsis.N Engl J Med. 2001; 344: 699-709Crossref PubMed Scopus (5036) Google Scholar, 3Abraham E Reinhart K Opal S et al.for the OPTIMIST Trial Study GroupEfficacy and safety of tifacogin (recombinant tissue factor pathway inhibitor) in severe sepsis: a randomized controlled trial.JAMA. 2003; 290: 238-247Crossref PubMed Scopus (803) Google Scholar, 4Warren BL Eid A Singer P et al.for the KyberSept Trial Study GroupHigh-dose antithrombin III in severe sepsis: a randomized controlled trial.JAMA. 2001; 286: 1869-1878Crossref PubMed Scopus (1129) Google Scholar Non-randomised heparin administration was associated with better outcome.5Polderman KH Girbes AR Drug intervention trials in sepsis: divergent results.Lancet. 2004; 363: 1721-1723Summary Full Text Full Text PDF PubMed Scopus (93) Google Scholar We would like to ask Nadel and colleagues to present the outcome in the subgroups receiving heparin versus those not.We declare that we have no conflict of interest. Simon Nadel and colleagues, in their randomised trial on drotrecogin alfa in children with severe sepsis (March 10, p 836),1Nadel S Goldstein B Williams MD et al.for the REsearching severe Sepsis and Organ dysfunction in children: a gLobal perspective (RESOLVE) study groupDrotrecogin alfa (activated) in children with severe sepsis: a multicentre phase III randomised controlled trial.Lancet. 2007; 369: 836-843Summary Full Text Full Text PDF PubMed Scopus (414) Google Scholar do not mention heparin. Treatment with heparins was a consistent confounder in three large trials of anticoagulant proteins for sepsis.2Bernard GR Vincent JL Laterre PF et al.for the Recombinant human protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study groupEfficacy and safety of recombinant human activated protein C for severe sepsis.N Engl J Med. 2001; 344: 699-709Crossref PubMed Scopus (5036) Google Scholar, 3Abraham E Reinhart K Opal S et al.for the OPTIMIST Trial Study GroupEfficacy and safety of tifacogin (recombinant tissue factor pathway inhibitor) in severe sepsis: a randomized controlled trial.JAMA. 2003; 290: 238-247Crossref PubMed Scopus (803) Google Scholar, 4Warren BL Eid A Singer P et al.for the KyberSept Trial Study GroupHigh-dose antithrombin III in severe sepsis: a randomized controlled trial.JAMA. 2001; 286: 1869-1878Crossref PubMed Scopus (1129) Google Scholar Non-randomised heparin administration was associated with better outcome.5Polderman KH Girbes AR Drug intervention trials in sepsis: divergent results.Lancet. 2004; 363: 1721-1723Summary Full Text Full Text PDF PubMed Scopus (93) Google Scholar We would like to ask Nadel and colleagues to present the outcome in the subgroups receiving heparin versus those not. We declare that we have no conflict of interest. Heparin in sepsis treatment – Authors' replyChristoph Pechlaner and Michael Joannidis raise an important question about heparin being a potential confounder in our trial of activated drotrecogin alfa in children with severe sepsis. In our trial, 62% of the patients in the drotrecogin alfa and placebo arms were receiving heparin at baseline. Differences in 28-day mortality between those receiving and not receiving heparin are shown in the table. The Breslow-Day test for subgroup interaction in the baseline heparin versus no heparin groups was 0·56, indicating that there was no statistical difference between the two groups with respect to treatment group mortality rates. Full-Text PDF" @default.
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• W2066125069 title "Heparin in sepsis treatment" @default.
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