title: Antithrombin and protein C in systemic inflammatory response syndrome.
abstract: 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.
authors.affiliation: 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
authors.forename: Islam
authors.initials: I
authors.lastname: Massad
authors.forename: Hamdi
authors.initials: H
authors.lastname: Abu-Ali
authors.forename: Christine
authors.initials: C
authors.lastname: Biron-Andreani
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Picot
authors.forename: Philippe
authors.initials: P
authors.lastname: Trinh-Duc
mesh_terms: 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
chemical_list: D000991:Antithrombins; D015415:Biomarkers; D011486:Protein C