Control of DIC after administration of ATIII in ICU septic patients
S Vasiliagou1 , E Andoniadou1 , A Bekridelis1 , K Kyparissi1 , I Galatianos1 , X Lagoudaki2 , O Ioannou2 , T Varvataki2 , CH Boboti3 and D Andoniadou3
1ICU
2Hematological Laboratory
3Biochemistry Laboratory, General Hospital 'G Gennimatas', 41 Ethnikis Aminis str, 54635 Thessaloniki, Greece
from 21st International Symposium on Intensive Care and Emergency Medicine
Brussels, Belgium. 20–23 March 2001
Critical Care 2001, 5(Suppl 1):P104 doi:10.1186/cc1171
Received 15 January 2001
Published 2 March 2001
Objective
To study the effectiveness of ATIII in critically ill septic patients with DIC.
Design
Prospective observational study.
Settings
An 8 bed medical-surgical ICU of a general hospital.
Patients
Septic adult patients with findings of DIC during a 1 year period.
Methods
A total of 45 patients (age 21–72) fulfilling the classical criteria of sepsis and DIC having similar APACHE II and MODS scores at admission were studied. These patients divided in two groups A and B including 23 and 22 patients respectively. Group A: All patients received ATIII in a loading dose (BW × [100 –Laboratory Value ATIII% × 2/3]) when ATIII levels in blood measured <60%. Blood derivatives were used when PTL <20,000 mm3, PT >20 s, fibrinogen <1 g/l and D-Dimers >500 ?g/l. Group B: Patients were treated according to the classical treatment. Hematological parameters Ht, Hb, PTL, WBC, PT, PTT, ATIII, Fibrinogen, D-Dimers, were measured every 8 h until their improvement and restoration.
Results
A significant differences in improvement of hematological parameters were observed between the two groups. In group A after a single dose of ATIII the values of PT (19.7 ± 2.5 vs 26.6 ± 4.1), PTT (49.4 ± 5.2 vs 54.9 ± 8.9), ATIII (70 ± 6 vs 37.6 ± 4.7), Fibrinogen (161 ± 18 vs 104 ± 14) and D-Dimers (177 ± 21 vs 264 ± 31) improved significantly after 12 h (P <0.05 for all comparisons). In 16/23 (Group A) patients received a single dose of ATIII, hematological disorders restored in first 32 h. The rest 7/23 patients needed a second dose in 48 h. In group B the hematological disorders remained for at least 5 days and restored beyond the 10th day.
Conclusions
The use of ATIII seems to be critical for the rapid improvement and stabilization in septic patients with hematological disorders.
