Abstract
Purpose
We hypothesized that antithrombin is more effective for disseminated intravascular
coagulation (DIC) than is gabexate mesilate, which is a protease inhibitor, suggested
from the previous studies. Initially, we compared the effects of antithrombin and
gabexate mesilate for treating infection-related DIC.
Methods
Sixteen adult patients with a diagnosis of DIC with infection who were assessed with
an acute DIC score 4 or higher at the admission to the intensive care unit were divided
into antithrombin-treated and gabexate mesilate–treated groups. White blood cell counts,
C-reactive protein, platelet counts, antithrombin, fibrin and fibrinogen degradation
product, d-dimer, fibrinogen, thrombin antithrombin complex, plasmin plasminogen complex, prothrombin
time, and activated partial thrombin time were measured on the day of admission and
on days 1, 3, 5, and 7 thereafter. Mortality over 28 days was also compared.
Results
Platelet counts and antithrombin were significantly higher in the antithrombin group
on day 7 and on days 5 and 7, respectively. Antithrombin increased to the normal level
on day 1 in the antithrombin group but on day 7 in the gabexate mesilate group. C-reactive
protein, fibrinogen degradation product, d-dimer, thrombin antithrombin complex, plasmin plasminogen complex, and prothrombin
time were lower in the antithrombin group; but the differences were not significant.
The 28-day mortality was 2 of 8 in the antithrombin group and 3 of 8 in the gabexate
mesilate group, but they were not significantly different.
Conclusions
Antithrombin may be a more effective treatment for coagulation and fibrinolysis disorders
than gabexate mesilate in infection-related DIC, but there was no difference in 28-day
mortality.
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Article Info
Publication History
Published online: December 28, 2011
Accepted:
June 1,
2011
Received in revised form:
May 30,
2011
Received:
April 30,
2011
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
