THE RESPONSE OF ANTITHROMBIN III ACTIVITY AFTER SUPPLEMENTATION DECREASES IN PROPORTION TO THE SEVERITY OF SEPSIS AND LIVER DYSFUNCTION
- 1 December 2008
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Shock
- Vol. 30 (6), 649-652
- https://doi.org/10.1097/shk.0b013e318173e396
Abstract
The decrease in the antithrombin III activity is thought to result from consumption by ongoing coagulation, degradation by neutrophil elastase, capillary leak syndrome, and impaired synthesis. A retrospective data analysis of patients with sepsis was conducted to investigate the response of antithrombin III activity after supplementation in patients with sepsis, and to determine what factors affect the response of antithrombin III activity. The study included 42 sepsis, 75 severe sepsis and 65 septic shock patients, who were administrated antithrombin III. Antithrombin III activity, platelet counts, coagulation and fibrinolytic markers were collected before administration and 24 hr after the supplementation. In the patients with septic shock, the response of antithrombin III activity after supplementation was 0.37 ± 1.21%/IU/kg body weight, which was significantly lower in comparison to those in the patients with sepsis (1.81 ± 1.75 ; P < 0.001) or severe sepsis (1.36 ± 1.65 ; P < 0.001). The patients with liver dysfunction had significantly lower response to antithrombin III activity than that of the patients without liver dysfunction (P < 0.0001). A stepwise multiple-linear regression analysis revealed that the severity of sepsis and liver function were independent predictors for the response to antithrombin III activity. These results suggest that the response to antithrombin III supplementation may be affected by both a systemic inflammation and impaired synthesis in patients with sepsisKeywords
This publication has 19 references indexed in Scilit:
- High-dose antithrombin III in the treatment of severe sepsis in patients with a high risk of death: Efficacy and safety*Critical Care Medicine, 2006
- Effect of long-term and high-dose antithrombin supplementation on coagulation and fibrinolysis in patients with severe sepsis*Critical Care Medicine, 2004
- High-Dose Antithrombin III in Severe SepsisJAMA, 2001
- Antithrombin III in patients with severe sepsis: a pharmacokinetic study.Intensive Care Medicine, 2000
- Antithrombin III in patients with severe sepsisIntensive Care Medicine, 1998
- Antithrombin III (ATILL) replacement therapy in patients with sepsis and/or postsurgical complications: a controlled double-blind, randomized, multicenter studyIntensive Care Medicine, 1998
- Septic Shock, Multiple Organ Failure, and Disseminated Intravascular CoagulationChest, 1992
- Thrombin generation in acute promyelocytic leukemiaBlood, 1984
- Liver dysfunction rather than intravascular coagulation as the main cause of low protein C and antithrombin III in acute leukemiaBlood, 1984
- Studies of the prothrombin activation pathway utilizing radioimmunoassays for the F2/F1 + 2 fragment and thrombin--antithrombin complexBlood, 1982