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Control of DIC after administration of ATIII in ICU septic patients

Objective

To study the effectiveness of ATIII in critically ill septic patients with DIC.

Design

Prospective observational study.

Settings

An 8 bed medical-surgical ICU of a general hospital.

Patients

Septic adult patients with findings of DIC during a 1 year period.

Methods

A total of 45 patients (age 21–72) fulfilling the classical criteria of sepsis and DIC having similar APACHE II and MODS scores at admission were studied. These patients divided in two groups A and B including 23 and 22 patients respectively. Group A: All patients received ATIII in a loading dose (BW × [100 –Laboratory Value ATIII% × 2/3]) when ATIII levels in blood measured <60%. Blood derivatives were used when PTL <20,000 mm3, PT >20 s, fibrinogen <1 g/l and D-Dimers >500 μg/l. Group B: Patients were treated according to the classical treatment. Hematological parameters Ht, Hb, PTL, WBC, PT, PTT, ATIII, Fibrinogen, D-Dimers, were measured every 8 h until their improvement and restoration.

Results

A significant differences in improvement of hematological parameters were observed between the two groups. In group A after a single dose of ATIII the values of PT (19.7 ± 2.5 vs 26.6 ± 4.1), PTT (49.4 ± 5.2 vs 54.9 ± 8.9), ATIII (70 ± 6 vs 37.6 ± 4.7), Fibrinogen (161 ± 18 vs 104 ± 14) and D-Dimers (177 ± 21 vs 264 ± 31) improved significantly after 12 h (P <0.05 for all comparisons). In 16/23 (Group A) patients received a single dose of ATIII, hematological disorders restored in first 32 h. The rest 7/23 patients needed a second dose in 48 h. In group B the hematological disorders remained for at least 5 days and restored beyond the 10th day.

Conclusions

The use of ATIII seems to be critical for the rapid improvement and stabilization in septic patients with hematological disorders.

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Vasiliagou, S., Andoniadou, E., Bekridelis, A. et al. Control of DIC after administration of ATIII in ICU septic patients. Crit Care 5, P104 (2001). https://doi.org/10.1186/cc1171

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Keywords

  • Single Dose
  • Adult Patient
  • Emergency Medicine
  • Fibrinogen
  • General Hospital