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Antithrombin III in cardiac surgery: an outcome study.

Abstract
A retrospective study examined the impact, in heparin resistant patients (HRP), of lyophilized antithrombin III (ATIII) upon five patient outcomes: intensive care unit stay (ICU-S), 24 hour chest tube drainage (CTD in ml), blood and blood product usage (BPU), development of postoperative coagulopathy (PO-Coag), and reoperation for bleeding (Re-Op). Data was collected from the medical records of 311 patients admitted to the hospital between 12/15/95 and 10/24/96. Subjects were divided into three groups based upon heparin resistance and hemostasis medication. Group 1 (n = 109) were HRP treated with increased heparin, Group 2 (n = 100) were HRP receiving ATIII, and Group 3 (n = 102) were non-HRP and served as controls. Group 2 was also subdivided by use of aminocaproic acid and time of ATIII administration. No significant differences were found between the groups for PO-Coag. and Re-Op. However, significant reduction in CTD (p = 0.05) was seen in the aminocaproic acid patients who were treated with ATIII pre-CPB or within the first 20 minutes of CPB. The CTD in this group was (419.37, +/- 72.96) as compared to Group 1 (782.88, +/- 360.94) and Group 3 (766.67, +/- 407.56). Other Group 2 subgroups showed significant differences in BPU, ICU-S and CTD. The results of this study support the notion that early identification and treatment of HRP with ATIII and aminocaproic acid may decrease postoperative blood loss.
AuthorsJ C Conley, P F Plunkett
JournalThe journal of extra-corporeal technology (J Extra Corpor Technol) Vol. 30 Issue 4 Pg. 178-83 (Dec 1998) ISSN: 0022-1058 [Print] United States
PMID10537578 (Publication Type: Journal Article)
Chemical References
  • Anticoagulants
  • Antifibrinolytic Agents
  • Antithrombin III
  • Heparin
  • Aminocaproic Acid
Topics
  • Aminocaproic Acid (therapeutic use)
  • Anticoagulants (therapeutic use)
  • Antifibrinolytic Agents (therapeutic use)
  • Antithrombin III (therapeutic use)
  • Blood Transfusion (statistics & numerical data)
  • Cardiopulmonary Bypass (adverse effects)
  • Drug Resistance
  • Female
  • Heparin
  • Humans
  • Length of Stay (statistics & numerical data)
  • Male
  • Middle Aged
  • Postoperative Hemorrhage (etiology)
  • Retrospective Studies
  • Treatment Outcome

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