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Hemostatic effects of antithrombin III supplementation during cardiac surgery: results of a prospective randomized investigation.

Publication ,  Journal Article
Slaughter, TF; Mark, JB; El-Moalem, H; Hayward, KA; Hilton, AK; Hodgins, LP; Greenberg, CS
Published in: Blood Coagul Fibrinolysis
January 2001

Failure to suppress thrombin generation during cardiac surgery promotes fibrin generation, fibrinolysis, and a consumptive coagulopathy. Acquired deficiencies of antithrombin III may play a contributory role. We hypothesized that antithrombin III supplementation to normal physiologic concentrations would decrease thrombin generation and potentially reduce peri-operative bleeding. Twenty patients undergoing coronary artery bypass graft surgery were randomized for this prospective, double-blind, placebo-controlled study. Ten patients received antithrombin III supplementation (50 U/kg) by intravenous infusion prior to incision, and 10 patients received a placebo. Blood samples were obtained pre-operatively, at 1 and 2 h following initiation of cardiopulmonary bypass (CPB), and at 1, 3, and 24 h after completion of CPB. Samples were analyzed for antithrombin III, thrombin-antithrombin III (TAT) complex, and D-dimer concentrations. Cumulative blood loss was recorded at 6 and 12 h after CPB. No statistically significant differences in patient demographics or total heparin dose administered were observed between groups. As expected, plasma antithrombin III concentrations were maintained near pre-operative values in the treatment group, but not in the placebo group. Despite this difference, no statistically significant alterations in generation of TAT complex, D-dimer, or blood loss occurred between groups. Antithrombin III supplementation to maintain normal physiologic concentrations during CPB did not alter significantly thrombin generation, fibrinolytic activity, or blood loss in adults undergoing elective cardiac surgery.

Duke Scholars

Published In

Blood Coagul Fibrinolysis

DOI

ISSN

0957-5235

Publication Date

January 2001

Volume

12

Issue

1

Start / End Page

25 / 31

Location

England

Related Subject Headings

  • Thrombin
  • Serine Proteinase Inhibitors
  • Prospective Studies
  • Preoperative Care
  • Middle Aged
  • Male
  • Humans
  • Hemostatics
  • Hemostasis
  • Double-Blind Method
 

Citation

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ICMJE
MLA
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Slaughter, T. F., Mark, J. B., El-Moalem, H., Hayward, K. A., Hilton, A. K., Hodgins, L. P., & Greenberg, C. S. (2001). Hemostatic effects of antithrombin III supplementation during cardiac surgery: results of a prospective randomized investigation. Blood Coagul Fibrinolysis, 12(1), 25–31. https://doi.org/10.1097/00001721-200101000-00004
Slaughter, T. F., J. B. Mark, H. El-Moalem, K. A. Hayward, A. K. Hilton, L. P. Hodgins, and C. S. Greenberg. “Hemostatic effects of antithrombin III supplementation during cardiac surgery: results of a prospective randomized investigation.Blood Coagul Fibrinolysis 12, no. 1 (January 2001): 25–31. https://doi.org/10.1097/00001721-200101000-00004.
Slaughter TF, Mark JB, El-Moalem H, Hayward KA, Hilton AK, Hodgins LP, et al. Hemostatic effects of antithrombin III supplementation during cardiac surgery: results of a prospective randomized investigation. Blood Coagul Fibrinolysis. 2001 Jan;12(1):25–31.
Slaughter, T. F., et al. “Hemostatic effects of antithrombin III supplementation during cardiac surgery: results of a prospective randomized investigation.Blood Coagul Fibrinolysis, vol. 12, no. 1, Jan. 2001, pp. 25–31. Pubmed, doi:10.1097/00001721-200101000-00004.
Slaughter TF, Mark JB, El-Moalem H, Hayward KA, Hilton AK, Hodgins LP, Greenberg CS. Hemostatic effects of antithrombin III supplementation during cardiac surgery: results of a prospective randomized investigation. Blood Coagul Fibrinolysis. 2001 Jan;12(1):25–31.

Published In

Blood Coagul Fibrinolysis

DOI

ISSN

0957-5235

Publication Date

January 2001

Volume

12

Issue

1

Start / End Page

25 / 31

Location

England

Related Subject Headings

  • Thrombin
  • Serine Proteinase Inhibitors
  • Prospective Studies
  • Preoperative Care
  • Middle Aged
  • Male
  • Humans
  • Hemostatics
  • Hemostasis
  • Double-Blind Method