Question About Xigris Therapy

ERNurse752, RN · Jan 8, 2003

Yep...I can recall one pt (have never started it in the ED, and tend to lose track of pts when they go to the floor...so that's hopefully why there's just one.)

Took care of a 54 y/o/w/f in the ED who came in with SOB/cough. 1 ppd smoker x 40 or so years, no other hx.

She had a double pneumonia and was in septic shock...worked with her for hours in the ED, trying to get her resp distress, hypoxia, and hypotension turned around. Finally got to the point where she was feeling somewhat better, sats were better, bp was better, and she was waiting on an ICU bed to open up, when my shift ended. (ABG's still weren't great, but not horrible.)

Came back in that night, and she had been intubated later that morning, and was on Neo and Xigris, as well as a Triadyne bed (rotational bed.)

She was on the vent and pretty critical for a few weeks, and in the hospital a couple more weeks after that, but she got off everything and went home.

:)

nimbex, RN · Jan 10, 2003

Yes! Yes ! Yes...... swanned on the balloon pump for severe refractory hypotension... 45 years old. The xigris period turned her around.... and we are using it more and more....

trick is it has to be started early.... and bleeding has to be monitored constantly..... don't give up on it yet.... instances may have been started too late.

Allison P · Jan 10, 2003

Thank you for your replies. I think in the cases I've seen Xigris has definitely been started too late. It's only used as a last resort by our physicians.

Thanks

Allison:)

rstewart · Jan 10, 2003

My understanding is that the major Xigris study to date only shows a 6% improvement in mortality. When you consider the dismal prognosis for severe sepsis patients, it shouldn't be surprising that "saves" are somewhat infrequent.

The $6800 price tag among other things has made usage around these parts infrequent as well.

whip65 · Aug 3, 2009

My understanding is that the major Xigris study to date only shows a 6% improvement in mortality. When you consider the dismal prognosis for severe sepsis patients, it shouldn't be surprising that "saves" are somewhat infrequent.
The $6800 price tag among other things has made usage around these parts infrequent as well.

Just today had a pt on Xigris. 1st time I've seen it. This pt definitely had severe sepsis and many co-morbidities before the drug was even started. So I think that it was started late. To complicate things the neph and ccs team decided to put in a TDC over a wire of the current triple lumen and the new triple lumen oozed probably a pint of blood before we could get it to stop! I have heard that bleeding is a complication from this drug but this pt was bleeding from mouth, nose, IV/STCVC sites, ect!!! I don't know if the risks really would have outweighed the benefits in this situation. Especially with the cost.............