Antithrombin III concentrate in the acute phase of thermal injury.
BACKGROUND
Thermal injury disrupts homeostasis by inducing subclinical disseminated intravascular coagulation, fibrinolysis. and an acquired deficiency of Antithrombin III (ATIII), a natural anticoagulant. As a result, thermally injured patients have a high incidence of hypercoagulability and thrombosis.


OBJECTIVE
ATIII (Human) concentrate was given to a thermally injured patient to evaluate safety, and dosage requirements in this setting.


METHODS
The patient was a 40 yr old male with a 68% total burn surface area, right femoral comminuted fracture, and C5-C6 subluxation sustained in a vehicular crash. He received nine infusions of AT III (H) concentrate (100-50 u/kg) within the first four days of injury.


RESULTS
The ATIII plasma level increased from 45% on admission (normal = 100+/-20%) to 120+/-25% in the next four days. During the 64 day hospitalization, there were 11 grafting procedures with an estimated blood loss (EBL)/procedure: 1140 cc; and EBL/grafted surface area ratio: 0.6 cc cm2. The average time to healing of the meshed autograft was 6.4 days.


CONCLUSIONS
ATIII (H) concentrate can be safely utilized in the acute phase of thermal injury: no excessive bleeding or prolongation of wound healing was documented.
Kowal-Vern
A
A
Department of Pathology, Loyola University Medical Center, Maywood, IL 60153, USA.
McGill
V
V
Walenga
J M
JM
Gamelli
R L
RL
D000208:Acute Disease; D000328:Adult; D000990:Antithrombin III / Q000008:administration & dosage / Q000032:analysis / Q000627:therapeutic use*; D016063:Blood Loss, Surgical; D002056:Burns / Q000097:blood / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D016038:Skin Transplantation
D000990:Antithrombin III