title: Antithrombin(H) concentrate infusions are safe and effective in patients with thermal injuries.
abstract: An antithrombin (AT) deficiency develops in patients with thermal injuries as a result of the subclinical disseminated intravascular coagulation. We conducted a pilot study to assess AT(Human [H]) concentrate infusions for safety and efficacy in thermal injury. Nine patients with burns who received Thrombate (Bayer Corporation, Berkeley, Calif) AT(H) concentrate infusions every 8 hours to raise the plasma level to 175% in the first 72 hours after injury were compared with 9 control patients with burns. Admission AT plasma levels were 45%+/-10% in patients treated with AT(H) versus 49%+/-18% in control patients (normal, 100%+/-20%). Day-2 to day-4 levels were 120%+/-25% in patients treated with AT(H) patients versus 50%+/-12% in the control patients (P < .002). In the group treated with AT(H), the time to wound healing was shorter for all body regions and was significantly shorter for the hand (P < .02). Compared with control patients, patients treated with AT(H) had similar blood loss per grafted area. A trend toward fewer autografting procedures, a shorter meshed autograft healing time, and a decreased hospital stay was found for the patients treated with AT(H). AT(H) concentrate infusions are safe with thermal injury and are a viable option to shorten the length of hospitalization and to promote graft viability and survival. Clinical trials to confirm the benefit of this medication in the acute phase of thermal injury would be worthwhile.
authors.affiliation: Department of Pathology, Loyola University Medical Center, Maywood, Ill. 60153, USA.
authors.forename: A
authors.initials: A
authors.lastname: Kowal-Vern
authors.forename: V
authors.initials: V
authors.lastname: McGill
authors.forename: J M
authors.initials: JM
authors.lastname: Walenga
authors.forename: R L
authors.initials: RL
authors.lastname: Gamelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000990:Antithrombin III / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002056:Burns / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011336:Probability; D012016:Reference Values; D016038:Skin Transplantation; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000990:Antithrombin III