A compelling case for the use of perioperative zymogen protein C for increased patient safety

Duane F. Bruley, J. M. Abdallah, Michael B Streiff, T. W. McGuire, K. C. Bruley, M. Duncan, R. Duncan, E. E. Thiessen, M. White, K. C. Bruley, S. B. Bruley

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

It is imperative to maintain normal blood fl ow to provide adequate oxygen supply to specifi c organs and cells, as well as for the removal of metabolic byproducts. Therefore, any situation that results in blood clotting can injure or kill living tissues. In this paper, we describe a case where a protein C defi cient subject who would, by all medical indicators, be at 100 % risk of experiencing thrombophlebitis, deep vein thrombosis, and or lung emboli, is able to escape all pathologies by using perioperative zymogen protein C (ZPC). This protein C defi cient patient has a long history of blood clotting, particularly from surgical procedures. The patient is 81 years old and fi rst experienced clotting due to hernia surgery in 1964, when he was hospitalized for 16 days post-surgery with life threatening complications. It was later determined in 1980, after many episodes, that the patient had hereditary protein C defi ciency at the 38 % level. In his hernia surgery, perioperative ZPC was used along with accepted anticoagulation procedures with no blood clots or other related side effects occurring. This procedure can greatly benefi t protein C defi cient patients, and could potentially fi nd use for non-PC defi cient patients in surgeries and a variety of other medical treatments. This particular case helps to validate the importance of ZPC in effecting safer surgery in high-risk patients. It also supports the mechanism of ZPC acting as an anticoagulant without causing bleeding. Most importantly, each clinical case study represents a unique combination of surgeon, hematologist, medical staff, and patient functioning as a coordinated team. In this case, smaller amounts of very expensive ZPC achieved safe and effi cacious results, which is hugely important for future clinical applications when considering the production cost of ZPC. More studies must be done to establish minimum dosing while achieving safe and effi cacious outcomes.

Original languageEnglish (US)
Title of host publicationOxygen Transport to Tissue XXXVIII
PublisherSpringer New York LLC
Pages15-21
Number of pages7
Volume923
ISBN (Print)9783319388083
DOIs
StatePublished - 2016
Event43rd Annual Meeting of the International Society on Oxygen Transport to Tissue, ISOTT 2015 - Wuhan, China
Duration: Jul 11 2015Jul 16 2015

Publication series

NameAdvances in Experimental Medicine and Biology
Volume923
ISSN (Print)00652598
ISSN (Electronic)22148019

Other

Other43rd Annual Meeting of the International Society on Oxygen Transport to Tissue, ISOTT 2015
CountryChina
CityWuhan
Period7/11/157/16/15

Fingerprint

Enzyme Precursors
Patient Safety
Protein C
Surgery
Blood
Blood Coagulation
Hernia
Oxygen supply
Thrombophlebitis
Medical Staff
Pathology
Embolism
Ambulatory Surgical Procedures
Venous Thrombosis
Anticoagulants
Byproducts
Thrombosis
Tissue
Hemorrhage
Oxygen

Keywords

  • Optimal dosage
  • Patient safety
  • PC deficiency
  • Surgery
  • Zymogen protein C (ZPC)

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Bruley, D. F., Abdallah, J. M., Streiff, M. B., McGuire, T. W., Bruley, K. C., Duncan, M., ... Bruley, S. B. (2016). A compelling case for the use of perioperative zymogen protein C for increased patient safety. In Oxygen Transport to Tissue XXXVIII (Vol. 923, pp. 15-21). (Advances in Experimental Medicine and Biology; Vol. 923). Springer New York LLC. https://doi.org/10.1007/978-3-319-38810-6_2

A compelling case for the use of perioperative zymogen protein C for increased patient safety. / Bruley, Duane F.; Abdallah, J. M.; Streiff, Michael B; McGuire, T. W.; Bruley, K. C.; Duncan, M.; Duncan, R.; Thiessen, E. E.; White, M.; Bruley, K. C.; Bruley, S. B.

Oxygen Transport to Tissue XXXVIII. Vol. 923 Springer New York LLC, 2016. p. 15-21 (Advances in Experimental Medicine and Biology; Vol. 923).

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Bruley, DF, Abdallah, JM, Streiff, MB, McGuire, TW, Bruley, KC, Duncan, M, Duncan, R, Thiessen, EE, White, M, Bruley, KC & Bruley, SB 2016, A compelling case for the use of perioperative zymogen protein C for increased patient safety. in Oxygen Transport to Tissue XXXVIII. vol. 923, Advances in Experimental Medicine and Biology, vol. 923, Springer New York LLC, pp. 15-21, 43rd Annual Meeting of the International Society on Oxygen Transport to Tissue, ISOTT 2015, Wuhan, China, 7/11/15. https://doi.org/10.1007/978-3-319-38810-6_2
Bruley DF, Abdallah JM, Streiff MB, McGuire TW, Bruley KC, Duncan M et al. A compelling case for the use of perioperative zymogen protein C for increased patient safety. In Oxygen Transport to Tissue XXXVIII. Vol. 923. Springer New York LLC. 2016. p. 15-21. (Advances in Experimental Medicine and Biology). https://doi.org/10.1007/978-3-319-38810-6_2
Bruley, Duane F. ; Abdallah, J. M. ; Streiff, Michael B ; McGuire, T. W. ; Bruley, K. C. ; Duncan, M. ; Duncan, R. ; Thiessen, E. E. ; White, M. ; Bruley, K. C. ; Bruley, S. B. / A compelling case for the use of perioperative zymogen protein C for increased patient safety. Oxygen Transport to Tissue XXXVIII. Vol. 923 Springer New York LLC, 2016. pp. 15-21 (Advances in Experimental Medicine and Biology).
@inproceedings{359b3b7e528a4b548b5af71a460ca20f,
title = "A compelling case for the use of perioperative zymogen protein C for increased patient safety",
abstract = "It is imperative to maintain normal blood fl ow to provide adequate oxygen supply to specifi c organs and cells, as well as for the removal of metabolic byproducts. Therefore, any situation that results in blood clotting can injure or kill living tissues. In this paper, we describe a case where a protein C defi cient subject who would, by all medical indicators, be at 100 {\%} risk of experiencing thrombophlebitis, deep vein thrombosis, and or lung emboli, is able to escape all pathologies by using perioperative zymogen protein C (ZPC). This protein C defi cient patient has a long history of blood clotting, particularly from surgical procedures. The patient is 81 years old and fi rst experienced clotting due to hernia surgery in 1964, when he was hospitalized for 16 days post-surgery with life threatening complications. It was later determined in 1980, after many episodes, that the patient had hereditary protein C defi ciency at the 38 {\%} level. In his hernia surgery, perioperative ZPC was used along with accepted anticoagulation procedures with no blood clots or other related side effects occurring. This procedure can greatly benefi t protein C defi cient patients, and could potentially fi nd use for non-PC defi cient patients in surgeries and a variety of other medical treatments. This particular case helps to validate the importance of ZPC in effecting safer surgery in high-risk patients. It also supports the mechanism of ZPC acting as an anticoagulant without causing bleeding. Most importantly, each clinical case study represents a unique combination of surgeon, hematologist, medical staff, and patient functioning as a coordinated team. In this case, smaller amounts of very expensive ZPC achieved safe and effi cacious results, which is hugely important for future clinical applications when considering the production cost of ZPC. More studies must be done to establish minimum dosing while achieving safe and effi cacious outcomes.",
keywords = "Optimal dosage, Patient safety, PC deficiency, Surgery, Zymogen protein C (ZPC)",
author = "Bruley, {Duane F.} and Abdallah, {J. M.} and Streiff, {Michael B} and McGuire, {T. W.} and Bruley, {K. C.} and M. Duncan and R. Duncan and Thiessen, {E. E.} and M. White and Bruley, {K. C.} and Bruley, {S. B.}",
year = "2016",
doi = "10.1007/978-3-319-38810-6_2",
language = "English (US)",
isbn = "9783319388083",
volume = "923",
series = "Advances in Experimental Medicine and Biology",
publisher = "Springer New York LLC",
pages = "15--21",
booktitle = "Oxygen Transport to Tissue XXXVIII",

}

TY - GEN

T1 - A compelling case for the use of perioperative zymogen protein C for increased patient safety

AU - Bruley, Duane F.

AU - Abdallah, J. M.

AU - Streiff, Michael B

AU - McGuire, T. W.

AU - Bruley, K. C.

AU - Duncan, M.

AU - Duncan, R.

AU - Thiessen, E. E.

AU - White, M.

AU - Bruley, K. C.

AU - Bruley, S. B.

PY - 2016

Y1 - 2016

N2 - It is imperative to maintain normal blood fl ow to provide adequate oxygen supply to specifi c organs and cells, as well as for the removal of metabolic byproducts. Therefore, any situation that results in blood clotting can injure or kill living tissues. In this paper, we describe a case where a protein C defi cient subject who would, by all medical indicators, be at 100 % risk of experiencing thrombophlebitis, deep vein thrombosis, and or lung emboli, is able to escape all pathologies by using perioperative zymogen protein C (ZPC). This protein C defi cient patient has a long history of blood clotting, particularly from surgical procedures. The patient is 81 years old and fi rst experienced clotting due to hernia surgery in 1964, when he was hospitalized for 16 days post-surgery with life threatening complications. It was later determined in 1980, after many episodes, that the patient had hereditary protein C defi ciency at the 38 % level. In his hernia surgery, perioperative ZPC was used along with accepted anticoagulation procedures with no blood clots or other related side effects occurring. This procedure can greatly benefi t protein C defi cient patients, and could potentially fi nd use for non-PC defi cient patients in surgeries and a variety of other medical treatments. This particular case helps to validate the importance of ZPC in effecting safer surgery in high-risk patients. It also supports the mechanism of ZPC acting as an anticoagulant without causing bleeding. Most importantly, each clinical case study represents a unique combination of surgeon, hematologist, medical staff, and patient functioning as a coordinated team. In this case, smaller amounts of very expensive ZPC achieved safe and effi cacious results, which is hugely important for future clinical applications when considering the production cost of ZPC. More studies must be done to establish minimum dosing while achieving safe and effi cacious outcomes.

AB - It is imperative to maintain normal blood fl ow to provide adequate oxygen supply to specifi c organs and cells, as well as for the removal of metabolic byproducts. Therefore, any situation that results in blood clotting can injure or kill living tissues. In this paper, we describe a case where a protein C defi cient subject who would, by all medical indicators, be at 100 % risk of experiencing thrombophlebitis, deep vein thrombosis, and or lung emboli, is able to escape all pathologies by using perioperative zymogen protein C (ZPC). This protein C defi cient patient has a long history of blood clotting, particularly from surgical procedures. The patient is 81 years old and fi rst experienced clotting due to hernia surgery in 1964, when he was hospitalized for 16 days post-surgery with life threatening complications. It was later determined in 1980, after many episodes, that the patient had hereditary protein C defi ciency at the 38 % level. In his hernia surgery, perioperative ZPC was used along with accepted anticoagulation procedures with no blood clots or other related side effects occurring. This procedure can greatly benefi t protein C defi cient patients, and could potentially fi nd use for non-PC defi cient patients in surgeries and a variety of other medical treatments. This particular case helps to validate the importance of ZPC in effecting safer surgery in high-risk patients. It also supports the mechanism of ZPC acting as an anticoagulant without causing bleeding. Most importantly, each clinical case study represents a unique combination of surgeon, hematologist, medical staff, and patient functioning as a coordinated team. In this case, smaller amounts of very expensive ZPC achieved safe and effi cacious results, which is hugely important for future clinical applications when considering the production cost of ZPC. More studies must be done to establish minimum dosing while achieving safe and effi cacious outcomes.

KW - Optimal dosage

KW - Patient safety

KW - PC deficiency

KW - Surgery

KW - Zymogen protein C (ZPC)

UR - http://www.scopus.com/inward/record.url?scp=84984851054&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84984851054&partnerID=8YFLogxK

U2 - 10.1007/978-3-319-38810-6_2

DO - 10.1007/978-3-319-38810-6_2

M3 - Conference contribution

SN - 9783319388083

VL - 923

T3 - Advances in Experimental Medicine and Biology

SP - 15

EP - 21

BT - Oxygen Transport to Tissue XXXVIII

PB - Springer New York LLC

ER -