title: The efficacy and safety of antithrombin and recombinant human thrombomodulin combination therapy in patients with severe sepsis and disseminated intravascular coagulation.
abstract: Recombinant human thrombomodulin (rhTM) is often used concomitantly with antithrombin (AT) to treat disseminated intravascular coagulation (DIC). This observational study aimed to investigate the efficacy and safety of AT+rhTM combination therapy.
  
  
  
  One hundred twenty-nine patients with severe sepsis and DIC participated in this study. Of these, 78 patients were treated with AT+rhTM (AT+rhTM group) and 51 patients were treated with AT alone (AT group). We compared coagulation and inflammation markers, Sequential Organ Failure Assessment score, and DIC score at day 0 (baseline) and day 7 between the 2 groups. Bleeding events and 28-day mortality were also compared.
  
  
  
  Platelet counts and D-dimer levels at day 7 significantly improved in the AT+rhTM group compared with the AT group, and 28-day mortality was significantly lower in the AT+rhTM group than in the AT group (AT+rhTM: 15.4% vs AT: 29.4%). During the study period, the incidence of bleeding complications was similar in both groups (AT+rhTM: 6.4% vs AT: 7.8%).
  
  
  
  Compared with AT monotherapy, combination therapy with AT and rhTM may be more effective in improving platelet counts and D-dimer levels, as well as reducing mortality, in patients with severe sepsis-associated DIC.
authors.affiliation: Department of Anesthesiology and Intensive Care, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasamamachi, Yufu City, Oita, 879-5593, Japan. Electronic address: yasu@oita-u.ac.jp.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Yasuda
authors.affiliation: Department of Anesthesiology and Intensive Care, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasamamachi, Yufu City, Oita, 879-5593, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Goto
authors.affiliation: Department of Anesthesiology and Intensive Care, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasamamachi, Yufu City, Oita, 879-5593, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ohchi
authors.affiliation: Department of Anesthesiology and Intensive Care, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasamamachi, Yufu City, Oita, 879-5593, Japan.
authors.forename: Takakuni
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Anesthesiology and Intensive Care, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasamamachi, Yufu City, Oita, 879-5593, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Koga
authors.affiliation: Department of Anesthesiology and Intensive Care, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasamamachi, Yufu City, Oita, 879-5593, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Kitano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000991:Antithrombins / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D003422:Critical Care; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D010976:Platelet Count; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy* / Q000401:mortality; D018180:Thrombomodulin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000991:Antithrombins; D018180:Thrombomodulin
keywords: Antithrombin (AT); Disseminated intravascular coagulation (DIC); Recombinant human thrombomodulin (rhTM); Severe sepsis