The effect of antithrombin III substitution therapy on components of the plasma protease systems in surgical patients

Abstract

Objective: To evaluate the possible effects of antithrombin III (AT III) concentrate therapy on components of the plasma protease systems in surgical intensive care patients. Design: Open randomised, prospective study. Setting: General intensive care units in secondary and tertiary care hospitals. Subjects: Eighty-three surgical patients with functional plasma activity of AT III below 80% of normal plasma pool value the day after multiple trauma or major abdominal surgery. Interventions: Intravenous infusion of AT III concentrate. Endpoints: To maintain plasma AT III activity above 90% of normal plasma pool value in the therapy group. Measurements and main results: AT III, prothrombin, prekallikrein, kallikrein inhibition, kallikrein-like activity, plasminogen, antiplasmin activity and plasmin-like activity were measured with chromogenic peptide substrate assays. AT III, prothrombin, prekallikrein and plasminogen were reduced on the inclusion day in all patients. The other variables were in the normal ran...