BACKGROUND: Pulmonary complications occur frequently after thermal injury. OBJECTIVE: This open pilot study was performed as an initial assessment of the safety and efficacy of antithrombin H [AT(H)] concentrate in ameliorating the respiratory morbidity during the acute phase of injury. MATERIALS & METHODS: Thirty-two patients were eligible for the study; of these, nine opted for treatment with q8 h [AT(H)]. The mean daily peak values of pulmonary parameters such as PaO(2)/FiO(2) ratio, and RAW scores were computed for days 1-8. RESULTS: Control and AT(H)-treated patients were similar in age, % total burn surface area, inhalation injury, and mortality. Forty-three percent of the burn controls, and 23% of the AT(H)-treated patients had pneumonia, p<0.01. The median hospital stay for both groups was 42 days; however, the median number of ventilatory days for burn controls was 23 days vs 10 days for AT(H)-treated patients. The AT(H)-treated patients had admission AT plasma levels of 46+/-14% vs 49+/-18% in burn controls, (normal=100+/-20%). The AT plasma level was maintained at 120+/-24% in the AT(H)-treated patients vs 50+/-15% in the burn control group for the first four days following the acute injury, p<0.002. Thrombate(R) concentrate infusions were, in general, well tolerated by patients. The median dose was 97 u/kg/dose q8 h. Compared to burn controls, AT(H)-treated patients had higher PaO(2)/FiO(2) ratios between days 4-6, p<0.01. In comparing these two groups with and without inhalation, airway resistance (assessed by the RAW score) was significantly lower in the AT(H)-treated group with inhalation compared to the burn controls with inhalation on days 2 and 6, p<0.02. CONCLUSIONS: With a trend toward decreased airway resistance during AT(H) concentrate infusions, and increased oxygenation, AT(H)-treated patients had significantly fewer episodes of pneumonia compared to controls. AT(H) concentrates may modify the impact of thrombin on acute inflammation, and improve respiratory function in the acute phase of thermal injury.
BACKGROUND: Pulmonary complications occur frequently after thermal injury. OBJECTIVE: This open pilot study was performed as an initial assessment of the safety and efficacy of antithrombin H [AT(H)] concentrate in ameliorating the respiratory morbidity during the acute phase of injury. MATERIALS & METHODS: Thirty-two patients were eligible for the study; of these, nine opted for treatment with q8 h [AT(H)]. The mean daily peak values of pulmonary parameters such as PaO(2)/FiO(2) ratio, and RAW scores were computed for days 1-8. RESULTS: Control and AT(H)-treated patients were similar in age, % total burn surface area, inhalation injury, and mortality. Forty-three percent of the burn controls, and 23% of the AT(H)-treated patients had pneumonia, p<0.01. The median hospital stay for both groups was 42 days; however, the median number of ventilatory days for burn controls was 23 days vs 10 days for AT(H)-treated patients. The AT(H)-treated patients had admission AT plasma levels of 46+/-14% vs 49+/-18% in burn controls, (normal=100+/-20%). The AT plasma level was maintained at 120+/-24% in the AT(H)-treated patients vs 50+/-15% in the burn control group for the first four days following the acute injury, p<0.002. Thrombate(R) concentrate infusions were, in general, well tolerated by patients. The median dose was 97 u/kg/dose q8 h. Compared to burn controls, AT(H)-treated patients had higher PaO(2)/FiO(2) ratios between days 4-6, p<0.01. In comparing these two groups with and without inhalation, airway resistance (assessed by the RAW score) was significantly lower in the AT(H)-treated group with inhalation compared to the burn controls with inhalation on days 2 and 6, p<0.02. CONCLUSIONS: With a trend toward decreased airway resistance during AT(H) concentrate infusions, and increased oxygenation, AT(H)-treated patients had significantly fewer episodes of pneumonia compared to controls. AT(H) concentrates may modify the impact of thrombin on acute inflammation, and improve respiratory function in the acute phase of thermal injury.
Authors: Hao Chen; Donghang Zheng; Jennifer Davids; Mee Yong Bartee; Erbin Dai; Liying Liu; Lyubomir Petrov; Colin Macaulay; Robert Thoburn; Eric Sobel; Richard Moyer; Grant McFadden; Alexandra Lucas Journal: Methods Enzymol Date: 2011 Impact factor: 1.600
Authors: Sebastian Rehberg; Marc O Maybauer; Perenlei Enkhbaatar; Dirk M Maybauer; Yusuke Yamamoto; Daniel L Traber Journal: Expert Rev Respir Med Date: 2009-06-01 Impact factor: 3.772
Authors: Sebastian Rehberg; Yusuke Yamamoto; Linda E Sousse; Collette Jonkam; Yong Zhu; Lillian D Traber; Robert A Cox; Donald S Prough; Daniel L Traber; Perenlei Enkhbaatar Journal: Crit Care Med Date: 2013-12 Impact factor: 7.598
Authors: Perenlei Enkhbaatar; Basil A Pruitt; Oscar Suman; Ronald Mlcak; Steven E Wolf; Hiroyuki Sakurai; David N Herndon Journal: Lancet Date: 2016-10-01 Impact factor: 79.321
Authors: Robert L Ball; John W Keyloun; Kathleen Brummel-Ziedins; Thomas Orfeo; Tina L Palmieri; Laura S Johnson; Lauren T Moffatt; Anthony E Pusateri; Jeffrey W Shupp Journal: Shock Date: 2020-08 Impact factor: 3.533
Authors: Sebastian Rehberg; Yusuke Yamamoto; Eva Bartha; Linda E Sousse; Collette Jonkam; Yong Zhu; Lillian D Traber; Robert A Cox; Daniel L Traber; Perenlei Enkhbaatar Journal: Crit Care Date: 2013-05-11 Impact factor: 9.097