Military intensive care part 3. Future directions.

Activated Protein C Activated Protein C has been shown to decrease mortality in sepsis [1]. It would seem to be most beneficial in a select group of patients (those with mid range APACHE scores). Sepsis is not a common presentation to a deployed field hospital, where the main patient group has suffered from major trauma, and tends to be evacuated within 48 hours. However, longer stays are more common amongst foreign nationals where the evacuation chain is often less clear or the possibility may not even be available. One of the side effects of APC is cerebral haemorrhage which would be a devastating complication in a young soldier. However on occasion the deployed Intensive Care Unit must be prepared to accept patients for longer periods when the evacuation chain is prolonged.