tailieunhanh - Báo cáo khoa học: "Antithrombin and hypercoagulability in sepsis: insights from thrombelastograph"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Antithrombin and hypercoagulability in sepsis: insights from thrombelastography? | Available online http content 11 1 115 Commentary Antithrombin and hypercoagulability in sepsis insights from thrombelastography Johannes N Hoffmann and Kerstin Schick Department of Surgery University of Munich GroBhadern Marchioninistr. 81377 Munchen Germany Corresponding author Johannes N Hoffmann Published 23 February 2007 This article is online at http content 11 1 115 2007 BioMed Central Ltd Critical Care 2007 11 115 doi cc5156 See related research by Gonano et al. http content 10 6 R160 Abstract Antithrombin AT has been used for over 25 years to successfully treat disseminated intravascular coagulation DIC . A four-day AT therapy in patients with DIC in the KyberSept trial has been related to a clear survival benefit in patients not receiving concomitant heparin. Gonano and coworkers performed thrombelastography TEG measurements in patients with severe sepsis and clearly showed hypercoagulability as defined by five TEG parameters compared to healthy controls. In the AT group they found a trend towards normalization of TEG parameters after treatment although this did not reach statistical significance. This first clinical evaluation of hypercoagulability during AT treatment could not provide evidence for an attenuation of coagulopathy an effect that might be due to high inter-individual variability. In a recent paper Gonano and coworkers 1 reported the potential failure of antithrombin AT therapy to modulate hypercoagulability as evident from TEG measurements. AT constitutes the principal physiological inhibitor of thrombin and of other serine proteases of the clotting cascade and has been shown to interfere with the clotting process at various sites 2 . AT activity is decreased in patients with trauma shock and sepsis by virtue of its consumption during complex formation with clotting factors and by degradation via granulocyte elastase 3 . The first application of AT in a .