Thromboelastography during treatment with activated protein C

Introduction

Activated protein C (rhAPC) infusion increases fibrinolysis, which is very difficult to evaluate with standard tests. We used TEG to monitor the coagulation in our patients during the infusion of rhAPC.

Materials and methods

Six patients with severe sepsis were treated with rhAPC (24 μg/kg/hour for 96 hours). TEG (ETEG 3000; Hemoscope Corp., Skokie IL, USA) was carried out on native blood before (T0), at 24 hours (T1), 48 hours (T2), 72 hours (T3), 96 hours (T4) during and 24 hours after the end (T5) of rhAPC treatment. Analysis of differences between data was carried out with the Student t test for paired data (differences statistically significant for P < 0.05).

Results

Data are expressed as the mean and standard deviation. Results obtained are shown in Table 1 and Figs 1 and 2. * indicates the statistically significant results.

Table 1 (abstract P346)

Figure 1

(abstract P346)

Figure 2

(abstract P346)

Discussion

TEG is a reliable tool for monitoring fibrinolysis during rhAPC. Fibrinolyisis is more evident during the first 48 hours of infusion, probably because of a new equilibrium in the coagulation system reached after that period.