Antithrombin can modulate coagulation, cytokine production, and expression of adhesion molecules in abdominal aortic aneurysm repair surgery.
We investigated the effects of antithrombin on coagulation, fibrinolysis, and production of cytokines and adhesion molecules in abdominal aortic aneurysm repair surgery. Sixteen patients for Y-shaped graft replacement of abdominal aortic aneurysm were divided into an antithrombin group and a control group. In the antithrombin group, 3000 U antithrombin was infused over 30 min before heparin administration and 24 h later. White blood cell counts, platelet counts, prothrombin time ratio, and serum concentrations of antithrombin, polymorphonuclear leukocyte elastase, interleukin (IL)-1beta, IL-6, IL-8, tumor necrosis factor-alpha, and adhesion molecules, and variables of coagulation and fibrinolysis were measured before surgery, at the end of surgery, and 1 and 2 days after surgery. The antithrombin concentration decreased in the control group, whereas it increased in the antithrombin group with significant differences between the groups. Prothrombin time ratio, concentrations of d-dimer, thrombin-antithrombin complex, and intercellular adhesion molecule-1 increased only in the control group and polymorphonuclear leukocyte elastase, IL-6, tumor necrosis factor-alpha, and vascular cell adhesion molecule-1 increased in both groups. They were significantly less in the antithrombin group except for intercellular adhesion molecule-1. In conclusion, antithrombin could decrease hypercoagulation and inflammatory activation during abdominal aortic aneurysm surgery, which may decrease adverse events.
Department of Anesthesiology, The University of Tokyo, Faculty of Medicine, Tokyo, Japan. nishit-tky@umin.ac.jp
Tomoki
T
Nishiyama
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D017544:Aortic Aneurysm, Abdominal / Q000188:drug therapy / Q000378:metabolism / Q000601:surgery*; D001777:Blood Coagulation / Q000187:drug effects* / Q000502:physiology; D015815:Cell Adhesion Molecules / Q000096:biosynthesis*; D016009:Chi-Square Distribution; D016207:Cytokines / Q000096:biosynthesis*; D005260:Female; D005343:Fibrinolytic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged
D015815:Cell Adhesion Molecules; D016207:Cytokines; D005343:Fibrinolytic Agents