Antithrombin III concentrate in the treatment of DIC: a retrospective follow-up study.
OBJECTIVE
To assess the clinical utility of antithrombin III (AT-III) substitution in adults with septicaemia in an intensive care unit.


METHODS
A retrospective follow-up study was performed in the adult intensive care unit of a large teaching hospital. Adults with septicaemia and AT-III levels less than 0.45 IU/ml were identified. AT-III administration, consisting of an intravenous bolus injection of 20 IU/kg, followed by continuous infusion of 20 IU/kg per 24 h, was given to 21 patients, while this was withheld in 21 age- and sex-matched controls. The severity of diffuse intravascular coagulation (DIC), APACHE II score, and type of septicaemia were analysed. The odds ratio was calculated for survival.


RESULTS
The base-line characteristics with regards to severity of DIC, APACHE scores and types of sepsis were comparable for the patients who received AT-III concentrates and those who did not. Mortality in the treated and non-treated groups was 76% (95% CI: 53-92%) and 57% (95% CI: 34-78%), respectively (p = 0.24). The odds ratio for survival was 2.4 if no AT-III concentrate was administered (95% CI: 0.537-11.5; p = 0.24).


CONCLUSIONS
The use of AT-III concentrates in the doses applied in adult intensive care patients with septicaemia does not appear to improve outcome in terms of mortality.
Center for Haemastasis, Thrombosis, Atherosclerosis and Inflammation Research, University of Amsterdam, Netherlands.
E J
EJ
van Beek
M A
MA
von der Möhlen
J W
JW
ten Cate
D P
DP
Brandjes
H R
HR
Büller
D000328:Adult; D000368:Aged; D000990:Antithrombin III / Q000627:therapeutic use*; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
D000990:Antithrombin III