Reduction of D-dimer levels after therapeutic administration of antithrombin in acquired antithrombin deficiency of severe sepsis.
BACKGROUND
In acute disseminated intravascular coagulation, the effect of antithrombin (AT) administration on elevated levels of D-dimer is not well established. In the present study, we report on changes in circulating levels of D-dimer in response to administration of AT in a series of patients with acquired AT deficiency due to severe sepsis.


METHODS
Eight consecutive critically ill medical patients presenting with acute disseminated intravascular coagulation associated with severe sepsis/septic shock received a single bolus infusion of AT over 30 minutes, aiming to achieve physiological AT levels. Haemostatic parameters including D-dimer were assessed prior to, 6 and 24 h after AT administration. An average of 42 +/- 9 U/kg body weight was infused.


RESULTS
Following AT substitution, elevated levels of D-dimer fell whereas AT levels rose.


CONCLUSIONS
These observations support the notion that AT can favourably affect fibrin degradation accompanying disseminated intravascular coagulation of severe sepsis.
Kountchev
Jordan
J
Division of General Internal Medicine, Department of Internal Medicine, Medical University Innsbruck, Austria. jordan.kountchev@uibk.ac.at
Bijuklic
Klaudija
K
Bellmann
Romuald
R
Wiedermann
Christian J
CJ
Joannidis
Michael
M
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D000991:Antithrombins / Q000172:deficiency* / Q000627:therapeutic use*; D003422:Critical Care / Q000379:methods; D016638:Critical Illness; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005338:Fibrin Fibrinogen Degradation Products / Q000187:drug effects* / Q000378:metabolism*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D018805:Sepsis / Q000097:blood* / Q000150:complications*; D016896:Treatment Outcome
D000925:Anticoagulants; D000991:Antithrombins; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D006493:Heparin