Antithrombin level and circuit thrombosis during hemofiltration after cardiopulmonary bypass.
Intensive Care Med
; 34(11): 2068-75, 2008 Nov.
Article
in En
| MEDLINE
| ID: mdl-18575842
ABSTRACT
OBJECTIVE:
Hemofilter thrombosis occurs frequently during continuous veno-venous hemofiltration in intensive care units. Among coagulation disorders, antithrombin deficiency has been shown to be linked to hemofilter thrombosis. We investigated whether there was an association between antithrombin level activity and hemofilter thrombosis occurrence during early continuous hemofiltration following cardiopulmonary bypass.DESIGN:
Prospective observational study.SETTING:
Intensive care unit in University Teaching Hospital. PATIENTS ANDPARTICIPANTS:
Forty-eight consecutive patients. MEASUREMENTS ANDRESULTS:
Antithrombin level activity was measured just before the start of hemofiltration, and repeated at 24 h intervals for a total of 3 days. Hemofilter thrombosis episodes were recorded at each 24-h interval following antithrombin level activity measurement. Subjects were classified as HT when one or more episodes of hemofilter thrombosis appeared in this period and NHT if none. Morbidity parameters and mortality were recorded. Mean initial antithrombin level activity was low and not different in HT and NHT groups at day 0 (60.6 +/- 20.9% vs. 63.4 +/- 19.9%, P = 0.68). Antithrombin level activity was lower at day 1 (47.2 +/- 12.0% vs. 58.2 +/- 15.2%, P = 0.03) and day 2 (41.2 +/- 15.3% vs. 53.5 +/- 14.1%, P = 0.04) in HT group. However, antithrombin level activity was not shown to be predictive of HT in multivariate analysis. Morbidity and mortality did not differ significantly between the two groups.CONCLUSION:
Only a weak association was found between antithrombin level activity and HT during early veno-venous hemofiltration post-cardiopulmonary bypass. This result was not confirmed in multivariate analysis. DESCRIPTOR Renal failure dialysis and hemofiltration.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Thrombosis
/
Cardiopulmonary Bypass
/
Antithrombins
/
Hemofiltration
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
En
Journal:
Intensive Care Med
Year:
2008
Document type:
Article
Affiliation country:
Francia