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Wojciech Gaszyński

Publications and source records attributed to Wojciech Gaszyński.

5 recordsLinked to original sources
PubMed2006

Results of severe sepsis treatment program using recombinant human activated protein C in Poland.

BACKGROUND: Recombinant human activated protein C (drotrecogin alfa [activated]--DAA) demonstrated in Phase III controlled clinical studies significant reduction of mortality in patients with severe sepsis and high risk of death. The aim of the study was to assess the therapeutic efficacy of DAA in patients included in the National Severe Sepsis Register in Poland. MATERIAL/METHODS: The analysis included 3233 cases of severe sepsis reported between 04.2003 and 11.2005. 302 patients (9.3%) were treated with DAA. The clinical course of the disease in DAA and non-DAA treatment groups was compared. Logistic regression models for the effects of independent variables on the risk of death (dependent variable) were developed. RESULTS: In the patients treated with DAA, the relative risk of death was lower by 31% than in those who were not treated. In a multivariate logistic regression model, the use of DAA was, independently of the patient's age, severity of the clinical condition and type of organ dysfunction, the most significant mortality-reducing factor in severe sepsis. CONCLUSIONS: The use of DAA in the treatment of severe sepsis proved to be a very effective method of mortality reduction. Controlled nationwide surveillance program contributed to its effective utilization. The National Severe Sepsis Register proved to be a very useful instrument for assessment of the course of the disease and treatment efficacy.

APACHE↗
PubMed2005

[Coma--the interdisciplinary problem].

5% of all patients admitted to emergency units suffer from disturbances of state of consciousness. Early assessment/appreciation of degree of unconsciousness and identification of its etiology influences on and sometimes decides success of its therapy. In the article below epidemiology, diagnosis, prognosis and main principles of procedures employed in senseless patients are discussed.

Coma↗
PubMed2004

Severe sepsis in Poland--results of internet surveillance of 1043 cases.

BACKGROUND: Severe sepsis is a clinical syndrome frequently occurring in intensive care units (ICUs) when systemic infection results in multiorgan dysfunction. No Polish data concerning treatment and prognosis in this group of patients have been available to date. MATERIAL/METHODS: The Polish Working Group for Sepsis introduced in 2003 internet registration of severe sepsis cases treated in ICUs in Poland. Information about severe sepsis were entered including the type of infection, clinical course, methods and results of treatment. RESULTS: From 20.04.2003 to 10.01.2004, 1043 severe sepsis cases were reported by 104 ICUs. Mean age of patients was 59 years. Mean duration of treatment was 19 days, with mortality rate of 55%. In 60% dysfunction of 4 or more organs was diagnosed. In 55% the underlying disease was surgical and abdominal cavity was the primary infection site (47%). Pathogens most likely to cause severe sepsis were G- (48%) and G+ (43%) bacteria, as well as fungi (21%). Positive blood culture was obtained in 45% of patients. Treatment involved antibiotic and support of organ function. Activated protein C was used in 8.2%, causing a reduction of mortality. CONCLUSIONS: Severe sepsis in Polish ICUs develops most frequently in the course of intra-abdominal infections. Dysfunction of 4 or more organs caused observed high mortality (55%) Internet surveillance proved to be useful method of collecting information, widely accepted by personnel of ICUs.

Female↗
PubMed2004

The use of drotrecogin alfa (activated) in severe sepsis during acute pancreatitis - two case studies.

BACKGROUND: Twenty-five percent of patients with diagnosed acute pancreatitis (AP) present a severe form of it. One of the most widespread complications of such a form is severe sepsis or septic shock, in which mortality can reach 80%. A complication of this state is multiple organ failure, which requires multi-directional treatment in an intensive care unit (ICU). Among the standard therapies are: control of the source of infection, supportive treatment of failed organ function, and others (e.g. dietary therapy, pain management, and physiotherapy). It is also now possible to use recombinant human activated protein C [drotrecogin alfa (activated); Xigris, Eli Lilly, USA] in the treatment of severe sepsis. CASE REPORT: In this study, the cases of two patients in whom severe sepsis was found during the course of acute pancreatitis are presented. In both cases it was established clinically (by laparotomy) and bacteriologically that necrosis-altered fragments of the pancreas were the sources of infection. CONCLUSIONS: Both the cases presented indicate that drotrecogin alfa (activated) interrupts the developmental cascade of severe sepsis. Proofs of the efficacy of the treatment were improvements in the functions of organs previously insufficient during the course of sepsis. The rapid elimination of the drug allowed planning therapy strategies (the possibility of conducting surgical operations and smaller therapeutic interventions) without the risk of increased bleeding. The decision to use Xigris in severe sepsis during AP should always include consideration of the risk of bleeding in connection with the local status within the pancreas.

APACHE↗