Effects of Antithrombin III on body cavity effusions, fluid balance, colloid osmotic pressure and hemodynamics in porcine septic shock

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Introduction

It has been suggested that Antithrombin III (AT III) might have an anti-inflammatory effect in addition to its well known anti-thrombotic properties. The aim of this study was to investigate the effects of AT III on abdominal and pleural effusions, fluid balance, colloid osmotic pressure (COP) and hemodynamics, in a porcine fecal peritonitis model.

Methods

This was a prospective randomized, controlled animal laboratory study. Fasted, anaesthetized, mechanically-ventilated and multi-catheterized pigs (20.6± 1.9 kg) received 1 g/kg body weight feces into the abdominal cavity to induce sepsis and were observed over 8 h. Before induction, animals were randomized to treatment with 200 IE/kg AT III (Kybernin^® P, Centeon Pharma GmbH; Marburg, Germany) (n=4) or to controls (NaCl 0.9%) (n=4).

Hemodynamic treatment scheme with ringer´s solution was based on ensuring baseline intrathoracic blood volume (ITBV). Hemodynamics and COP were measured before sepsis induction and 4 h and 8 h afterwards. Cumulative fluid balance was calculated after 4 and 8 h. Abdominal and pleural effusion volumes were obtained after sacrificing the animals.

Results

See Table.

Conclusion

In the AT III treated group both abdominal and pleural effusion volumes were lower than in the controls. COP values 4 h after sepsis induction were higher and the cumulative fluid balance lower. This may indicate that AT III has a positive effect on capillary leakage in septic shock.

Table 1