Antithrombin and protein C in systemic inflammatory response syndrome.
Coronary artery bypass grafting with cardiopulmonary bypass can induce systemic inflammatory response syndrome. To assess the prevalence of preoperative antithrombin and protein C deficiencies in relation to the incidence of this syndrome, antithrombin and protein C levels were measured in 130 patients undergoing coronary artery bypass grafting with cardiopulmonary bypass. Systemic inflammatory response syndrome developed in 36 (27.7%) patients who were predominantly male, had a lower EuroSCORE, longer cardiopulmonary bypass time, higher pre-bypass temperature, and shorter activated coagulation time. Logistic regression showed that predictive factors included bypass duration and pre-bypass temperature; however, low antithrombin levels appeared to be a negative predictive factor. Antithrombin levels were < 80% in 33.8% of patients, and 11.6% had protein C levels < 80%. Postoperative antithrombin and protein C deficiencies are not uncommon in adults undergoing cardiac surgery with cardiopulmonary bypass, but detection of these deficits did not identify patients at increased risk of systemic inflammatory response syndrome.
Massad
Islam
I
Division of Cardiac Anesthesia, Department of General Surgery, Anesthesia and Intensive Care, Jordan University Hospital, PO Box 13046, Amman 11942, Jordan. islam_wafa@yahoo.com
Abu-Ali
Hamdi
H
Biron-Andreani
Christine
C
Picot
Marie-Christine
MC
Trinh-Duc
Philippe
P
D000328:Adult; D000991:Antithrombins / Q000032:analysis* / Q000172:deficiency; D015415:Biomarkers / Q000097:blood; D001778:Blood Coagulation Disorders / Q000453:epidemiology; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011486:Protein C / Q000032:analysis*; D020151:Protein C Deficiency / Q000097:blood / Q000453:epidemiology; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000209:etiology
D000991:Antithrombins; D015415:Biomarkers; D011486:Protein C