Correction of Antithrombin III Deficiency in Disseminated Intravascular Coagulation
General Reanimatology
View Archive Info| Field | Value | |
| Title |
Correction of Antithrombin III Deficiency in Disseminated Intravascular Coagulation
Коррекция дефицита антитромбина III при диссеминированном внутрисосудистом свертывании |
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| Creator |
Ye. Neporada L.
N. Vorobyeva A. E. Nedashkovsky V. Е. Непорада Л. Н. Воробьева А. Э. Недашковский В. |
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| Description |
Although antithrombin (AT) III concentrate therapy is attended by an increased risk of hemorrhage, the data available in the literature suggest that the agent may have a positive effect on outcome in disseminated intravascular coagulation (DIC). Administration of fresh frozen plasma (FFP) is associated with a less risk of hemorrhage; however, there is no evidence for its impact on prognosis in DIC. Objective: to compare the effects of AT concentrate and FFP on the activity of AT and on the clinical course of DIC. Subjects and methods. Forty-three patients diagnosed as having as DIC (according to the JAAM scale) and <70% AT deficiency were included into a randomized clinical study. The inclusion criteria were as follows: age less than 16 years and more than 75 years; malignancy; hemorrhage; hemostatic therapy; a thrombocytopenia of <50X109/l. The patients were randomized into 3 groups: A) AT concentrate 500— 1000 IU/day; B) FFP 10 ml/kg/day; C) combined therapy. The agents were daily administered for 4 days in a persistent AT deficiency of 70%. Nadroparin, 95 IU AXa/kg/day, was used as concurrent therapy. Results. The activity of AT substantially increased in Group A and great differences between Groups A and B preserved during therapy: 69±16 and 51±14% (p=0.007); 72±18 and 56±13% (p=0.02); 73±14 and 57±16% (p=0.03), respectively. No significant differences were found in the severity of respiratory disorders, dysfunction of other organs, DIC scale scores, the incidence of hemorrhages (2 cases in Group A), allergic reactions (2 cases of urticaria in Group C) and in 30-day mortality — 40, 53.3, and 30.8% in Groups A, B, and C, respectively. Conclusion. As compared with FFP and combined therapy, AT concentrate therapy for DIC provides a more effective correction of AT deficiency. Further studies are needed to compare the impact of three therapy modalities on the outcome and incidence of complications in DIC. Key words: disseminated intravascular coagulation (DIC), diagnostic criteria for DIC, antithrombin III deficiency, antithrombin III concentrate, fresh frozen plasma.
Несмотря на то, что терапия концентратом антитромбина III (AT) сопровождается повышенным риском кровотечения, литературные данные свидетельствуют о возможном положительном влиянии препарата на исход при ДВС-син-дроме. Введение свежезамороженной плазмы (СЗП) связано с меньшим риском кровотечения, однако ее влияние на прогноз при ДВС-синдроме не доказано. Цель исследования — сравнить эффекты концентрата АТ и СЗП на активность АТ и клиническое течение ДВС-синдрома. Материал и методы. 43 пациента с диагнозом ДВС-синдрома (по шкале JAAM) и дефицитом АТ |
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| Publisher |
FSBI "SRIGR" RAMS
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| Date |
2008-10-20
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| Type |
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion Рецензированная статья |
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| Format |
application/pdf
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| Identifier |
http://www.reanimatology.com/rmt/article/view/658
10.15360/1813-9779-2008-5-49 |
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| Source |
General Reanimatology; Том IV № 5 2008 г.; 49
Общая реаниматология; Том IV № 5 2008 г.; 49 2411-7110 1813-9779 10.15360/1813-9779-2008-5 |
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| Language |
rus
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| Relation |
http://www.reanimatology.com/rmt/article/view/658/697
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| Rights |
Authors who publish with this journal agree to the following terms:Authors retain copyright and grant the journal right of first publication, with the work 6 month after publication simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
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