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Efficacy of antithrombin administration in the acute phase of burn injury


Severe burn injury is characterized by the activation of coagulation, decreased fibrinolytic activity and decreased natural anticoagulant activity. The aim of our study was to investigate the effect of antithrombin administration on the coagulation status and on organ function in the early postburn period.


Thirty-one patients admitted to the burn ICU were randomized into two groups, antithrombin-treated (n = 15) and control (n = 16), for four consecutive days after thermal injury. The clinical data, coagulation parameters and fibrinolysis parameters were compared and the adverse effects were monitored.


Significant differences in the time trend of D-dimers and thrombin–antithrombin complexes were observed between antithrombin-treated and control groups (decrease in the antithrombin-treated group and increase in the control group). According to the International Society on Thrombosis and Hemostasis criteria, disseminated intravascular coagulation (DIC) diagnosis was set for 28 from 31 patients. The presence of overt DIC was associated with mortality (P = 0.002). The Sequential Organ Failure Assessment score time trend differed significantly between the two investigation groups (decreased in the treated group and did not change in the control group). Antithrombin-treated patients had an absolute reduction in 28-day mortality of 25% compared with the control group (P = 0.004). No treatment-related side effects were observed.


Treatment with antithrombin seems to affect the coagulation status and to reduce multiple organ failure incidence and mortality in the early postburn period.

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Lavrentieva, A., Houris, I., Aspragathou, S. et al. Efficacy of antithrombin administration in the acute phase of burn injury. Crit Care 12 (Suppl 2), P208 (2008).

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