Issue |
J Extra Corpor Technol
Volume 30, Number 4, December 1998
|
|
---|---|---|
Page(s) | 178 - 183 | |
DOI | https://doi.org/10.1051/ject/1998304178 | |
Published online | 14 August 2023 |
Original Article
Antithrombin III in Cardiac Surgery: An Outcome Study
Maine Medical Center, Portland, Maine, and Northeastern University, Boston, Massachusetts
* Address correspondence to: James Conley, BS, CCP, Maine Medical Center, 22 Bramhall Street, Portland, ME 04102
A retrospective study examined the impact, in heparin resistant patients (HRP), of lyophilized antithrombin III (ATIII) upon five patient outcomes: intensive care unit stay (ICU-S), 24 hour chest tube drainage (CTD in ml), blood and blood product usage (BPU), development of post-operative coagulopathy (PO-Coag), and reoperation for bleeding (Re-Op). Data was collected from the medical records of 311 patients admitted to the hospital between 12/15/95 and 10/24/96.
Subjects were divided into three groups based upon heparin resistance and hemostasis medication. Group 1 (n=l09) were HRP treated with increased heparin, Group 2 (n=100) were HRP receiving ATIII, and Group 3 (n=102) were non-HRP and served as controls. Group 2 was also subdivided by use of aminocaproic acid and time of ATIII administration.
No significant differences were found between the groups for PO-Coag. and Re-Op. However, significant reduction in CTD (p=0.05) was seen in the aminocaproic acid patients who were treated with ATIII pre-CPB or within the first 20 minutes of CPB. The CTD in this group was (419.37, ± 72.96) as compared to Group 1 (782.88, ± 360.94) and Group 3 (766.67, ± 407.56). Other Group 2 subgroups showed significant differences in BPU, ICU-S and CTD.
The results of this study support the notion that early identification and treatment of HRP with ATIII and aminocaproic acid may decrease postoperative blood loss.
Key words: cardiopulmonary bypass / antithrombin III / patient outcome / heparin resistance
© 1998 AMSECT
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