The efficacy of antithrombin administration in the acute phase of burn injury.
Severe burn injury is characterized by the activation of coagulation, decreased fibrinolytic activity and decreased natural anticoagulant activity. The aim of our study was to investigate the effect of antithrombin (AT) administration on coagulation status and on organ function in the early post-burn period. Thirty-one patients were admitted to the burn intensive care unit and were then randomised into two groups (AT-treated and non-AT-treated) for four consecutive days after thermal injury. The clinical data, coagulation and fibrinolysis parameters were compared and the adverse effects were monitored. Significant differences in the time course of coagulation markers (thrombin/AT complexes, tissue plasminogen activator, D-dimer) were observed between AT-treated and non-AT treated groups. According to the International Society on Thrombosis and Haemostasis criteria, disseminated intravascular coagulation (DIC) diagnosis was made in 28 of 31 patients. The presence of overt DIC was associated with mortality (p < 0.001). The Sequential Organ Failure Assessment (SOFA) score time trend differed significantly between the two investigation groups (decreased in the treated group and did not change in the non-AT-treated group). AT-treated patients had an absolute reduction in a 28-day mortality of 25% as compared to the non-AT-treated group (p = 0.004). No treatment related side effects were observed. Treatment with AT seems to affect the coagulation status and reduce multiple organ failure incidence and mortality in the early post-burn period.
Lavrentieva
Athina
A
Burn Intensive Care Unit, Papanicolaou General Hospital, Thessaloniki, Greece.
Kontakiotis
Theodore
T
Bitzani
Militsa
M
Parlapani
Aggeliki
A
Thomareis
Olympia
O
Scourtis
Harisios
H
Tsotsolis
Nicolaos
N
Lazaridis
Lambis
L
Giala
Maria-Amalia
MA
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000991:Antithrombins / Q000008:administration & dosage* / Q000009:adverse effects; D001777:Blood Coagulation / Q000187:drug effects; D001780:Blood Coagulation Tests; D002056:Burns / Q000150:complications* / Q000401:mortality; D003422:Critical Care; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy* / Q000209:etiology* / Q000401:mortality; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D011446:Prospective Studies; D012720:Severity of Illness Index; D013917:Thrombin / Q000096:biosynthesis / Q000378:metabolism; D016896:Treatment Outcome
D000991:Antithrombins; D013917:Thrombin