Use of antithrombin III in critical patients

Díaz-Cremades, Juan; Lorenzo, RJ De; Sánchez, Marco; Moreno, Mar; Alsar, M J; Bosch, J. M.; Fajardo, Laurie L.; González, D.; Guerrero, D.

doi:10.1007/bf01705725

Cited by 30 publications

(11 citation statements)

References 31 publications

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“…The best replacement therapy is FFP. Clinical studies of antithrombin concentrate in severe blunt trauma and in critical care have shown no benefit [338,339]. …”

Section: Resultsmentioning

confidence: 99%

Management of bleeding following major trauma: an updated European guideline

et al. 2010

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IntroductionEvidence-based recommendations are needed to guide the acute management of the bleeding trauma patient, which when implemented may improve patient outcomes.MethodsThe multidisciplinary Task Force for Advanced Bleeding Care in Trauma was formed in 2005 with the aim of developing a guideline for the management of bleeding following severe injury. This document presents an updated version of the guideline published by the group in 2007. Recommendations were formulated using a nominal group process, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) hierarchy of evidence and based on a systematic review of published literature.ResultsKey changes encompassed in this version of the guideline include new recommendations on coagulation support and monitoring and the appropriate use of local haemostatic measures, tourniquets, calcium and desmopressin in the bleeding trauma patient. The remaining recommendations have been reevaluated and graded based on literature published since the last edition of the guideline. Consideration was also given to changes in clinical practice that have taken place during this time period as a result of both new evidence and changes in the general availability of relevant agents and technologies.ConclusionsThis guideline provides an evidence-based multidisciplinary approach to the management of critically injured bleeding trauma patients.

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“…The best replacement therapy is FFP. Clinical studies of antithrombin concentrate in severe blunt trauma and in critical care have shown no benefit [338,339]. …”

Section: Resultsmentioning

confidence: 99%

Management of bleeding following major trauma: an updated European guideline

et al. 2010

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“…Conventional doses of AT-III, such as 50 U/kg of body weight, have been used clinically to treat sepsis and disseminated intravascular coagulation and to prevent further activation of the clotting cascade associated with consumption of AT-III (2). Because the clotting cascade is also activated after organ transplantation, some groups administer AT-III to patients who have undergone liver transplantation (3).…”

mentioning

confidence: 99%

High dose of antithrombin III induces indefinite survival of fully allogeneic cardiac grafts and generates regulatory cells

Aramaki

Takayama²,

Yokoyama³

et al. 2003

Transplantation

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“…Another prospective, open, randomized trial was published in 1994. 78 In this study, 36 patients with sepsis and multiple trauma were enrolled; 20 patients received AT concentrate, and 16 patients received placebo. Antithrombin was given as a 60 IU/kg loading dose, followed by 10 IU/kg every 6 h. No differences between the two groups were found in hemostasis parameters or evolving APACHE II scores.…”

Section: What Experiences Exist With At Concentrate In Animal Models mentioning

confidence: 99%

Therapeutic Use of Antithrombin Concentrate in Sepsis

Balk

Emerson²,

Fourrier³

et al. 1998

Semin Thromb Hemost

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Sepsis and its associated complications of disseminated intravascular coagulation (DIC) and multiple organ dysfunction syndrome (MODS) continue to be a major cause of morbidity and mortality. Improved detection of all forms of DIC is essential to assure earlier diagnosis. Studies already indicate that the therapeutic use of antithrombin (AT) concentrate may produce a more positive outcome for sepsis-associated DIC. If DIC could be identified earlier and AT concentrate could then be given earlier in the sepsis continuum, study results for the use of AT concentrate in humans might reveal a statistically significant difference versus placebo, and the efficacy of AT concentrate for this syndrome is more likely to be proved. Fixed-bolus doses of AT concentrate based on body weight are currently preferred, but improved, user-friendly assays for plasma AT levels would permit more rapid turnaround time for AT results and could help fine-tune the use of AT concentrate to the specific needs of each patient. Clinical trials involving the therapeutic use of AT concentrate in sepsis should continue, and it can be hoped that their design will reflect the concepts and conclusions offered by this panel of investigators.

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Use of antithrombin III in critical patients

Abstract: The results suggest that the administration of AT III concentrates to critical patients with acquired low levels, but without manifest DIC, may not be justified; although further studies on a larger population are required to establish definite conclusions.

Cited by 30 publications

References 31 publications

Management of bleeding following major trauma: an updated European guideline

Management of bleeding following major trauma: an updated European guideline

High dose of antithrombin III induces indefinite survival of fully allogeneic cardiac grafts and generates regulatory cells

Therapeutic Use of Antithrombin Concentrate in Sepsis

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