title: [Therapy with high-doses of antithrombin III in patients with septic shock and agranulocytosis].
abstract: OBJECTIVE
  The aim of the study was to assess efficacy of high-doses ofantithrombin 111 (AT) for treatment of septic shock in patients with an agranulocytosis.
  
  
  METHODS
  Prospective, controlled study.
  
  
  METHODS
  29 patients from 18 to 74 years old, with blood diseases complicated with septic shock Dates of study: from 2006 to 2012.
  
  
  METHODS
  The patients were randomized into two groups. Group-1 included 14 patients, who did not receive AT and group-2 included 15 patients who received AT.
  
  
  RESULTS
  Demographic indicators, condition severity according to APACHE II, level of thrombocytopenia, levels ofplasma procalcitonin, interleukin-6 (IL-6) and C-reactive protein (CRP) were the same in both groups. Level of AT was decreased in both groups; however it was higher in the group-1 (50% vs. 60%, p < 0.05). In the group-1, microorganisms were found in the blood of 9 patients. In the group-2, the microorganisms were found in the blood of 11 patients. Inflammation markers were decreased after the treatment of septic shock in both groups (p<0.05). The decreasing of procalcitonin in group-1 was from 43.8 to 1 ng/ml in 14 days and from 12.8 to 1.6 ng/ml in 7 days in group-2. The decreasing of CRP in group-1 was from 224 to 114 mg/l in 7 days and from 146 to 60 mg/l in 14 days in group-2. The decreasing of IL-6 in group-1 was from 1617 to 100 pg/ml in 3 days and from 5895 to 77 pg/ml in 7 days in group-2. A level of AT was increased only in group-2 (under 12% per day). 28-day survival was higher in group-2 (60 +/- 13% vs. 45 +/- 13%, p<0.05). We did not find any complications of the treatment with AT concentrate.
  
  
  CONCLUSIONS
  Treatment of septic shock with high-doses of antithrombin III was effective and safe in patients with an agranulocytosis.
authors.forename: G M
authors.initials: GM
authors.lastname: Galstian
authors.forename: A V
authors.initials: AV
authors.lastname: Krechetova
authors.forename: V V
authors.initials: VV
authors.lastname: Troitskaia
authors.forename: P M
authors.initials: PM
authors.lastname: Makarova
authors.forename: N A
authors.initials: NA
authors.lastname: Shutova
authors.forename: É G
authors.initials: ÉG
authors.lastname: Gemdzhian
authors.forename: E B
authors.initials: EB
authors.lastname: Orel
authors.forename: S A
authors.initials: SA
authors.lastname: Kesel'man
authors.forename: V G
authors.initials: VG
authors.lastname: Savchenko
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D000990:Antithrombin III / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000991:Antithrombins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D006402:Hematologic Diseases / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012772:Shock, Septic / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000991:Antithrombins; D000990:Antithrombin III