OBJECTIVE: During cardiac operations with cardiopulmonary bypass surgery, antithrombin is consumed and low levels of antithrombin activity are commonly observed at admission to the intensive care unit (ICU). This study investigates the association between antithrombin activity at admission to the ICU (ICU-antithrombin activity) and various outcome variables. DESIGN: The authors conducted a prospective, observational cohort study. SETTING: The study was conducted at a university hospital. PATIENTS: The study consisted of 647 consecutive patients who had undergone cardiac surgery with cardiopulmonary bypass. MEASUREMENTS AND MAIN RESULTS: ICU-antithrombin activity significantly (p < .001) decreased with respect to preoperative values. As seen with univariate analysis, low levels of ICU-antithrombin activity were significantly associated with higher blood loss, prolonged mechanical ventilation time and ICU stay, a higher incidence of allogeneic blood products use, surgical reexploration, low cardiac output syndrome, adverse neurologic events, thromboembolic events, renal dysfunction, and hospital mortality. When corrected for the other explanatory variables, low levels of ICU-antithrombin activity remained independently associated with a prolonged ICU stay (p = .003) and with a higher incidence of surgical reexploration (p = .023), adverse neurologic events (p = .001), and thromboembolic events (p = .036). An ICU-antithrombin activity value of <58% was found to be predictive of prolonged ICU stay, with a sensitivity of 67% and a specificity of 83%. CONCLUSIONS: Low levels of ICU-antithrombin activity are associated with a poor outcome in cardiac surgery; ICU-antithrombin activity is predictive of prolonged ICU stay.
OBJECTIVE: During cardiac operations with cardiopulmonary bypass surgery, antithrombin is consumed and low levels of antithrombin activity are commonly observed at admission to the intensive care unit (ICU). This study investigates the association between antithrombin activity at admission to the ICU (ICU-antithrombin activity) and various outcome variables. DESIGN: The authors conducted a prospective, observational cohort study. SETTING: The study was conducted at a university hospital. PATIENTS: The study consisted of 647 consecutive patients who had undergone cardiac surgery with cardiopulmonary bypass. MEASUREMENTS AND MAIN RESULTS: ICU-antithrombin activity significantly (p < .001) decreased with respect to preoperative values. As seen with univariate analysis, low levels of ICU-antithrombin activity were significantly associated with higher blood loss, prolonged mechanical ventilation time and ICU stay, a higher incidence of allogeneic blood products use, surgical reexploration, low cardiac output syndrome, adverse neurologic events, thromboembolic events, renal dysfunction, and hospital mortality. When corrected for the other explanatory variables, low levels of ICU-antithrombin activity remained independently associated with a prolonged ICU stay (p = .003) and with a higher incidence of surgical reexploration (p = .023), adverse neurologic events (p = .001), and thromboembolic events (p = .036). An ICU-antithrombin activity value of <58% was found to be predictive of prolonged ICU stay, with a sensitivity of 67% and a specificity of 83%. CONCLUSIONS: Low levels of ICU-antithrombin activity are associated with a poor outcome in cardiac surgery; ICU-antithrombin activity is predictive of prolonged ICU stay.
Authors: Gonzalo Sirgo; José Luis Pérez-Vela; Pablo Morales; Manuel Del Rey; Joan Vendrell; Cristina Gutierrez; Jordi Rello Journal: Intensive Care Med Date: 2006-03-01 Impact factor: 17.440
Authors: Sean Garvin; Daniel Fitzgerald; Jochen D Muehlschlegel; Tjörvi E Perry; Amanda A Fox; Stanton K Shernan; Charles D Collard; Sary Aranki; Simon C Body Journal: Anesth Analg Date: 2010-02-08 Impact factor: 5.108
Authors: Sean Garvin; Jochen D Muehlschlegel; Tjörvi E Perry; Junliang Chen; Kuang-Yu Liu; Amanda A Fox; Charles D Collard; Sary F Aranki; Stanton K Shernan; Simon C Body Journal: Anesth Analg Date: 2009-10-09 Impact factor: 5.108
Authors: Ruwan Gunaratne; Shekhar Kumar; James W Frederiksen; Steven Stayrook; Jens L Lohrmann; Kay Perry; Kristin M Bompiani; Charlene V Chabata; Nabil K Thalji; Michelle D Ho; Gowthami Arepally; Rodney M Camire; Sriram Krishnaswamy; Bruce A Sullenger Journal: Nat Biotechnol Date: 2018-06-04 Impact factor: 54.908
Authors: Domenico Paparella; Giangiuseppe Cappabianca; Giuseppe Scrascia; Giuseppe Fiore; Andreas Paramythiotis; Nicola Di Bari; Maria Pia Trisorio Liuzzi; Mohamed F Ibrahim; Tommaso Fiore; Luigi de Luca Tupputi Schinosa Journal: J Thromb Thrombolysis Date: 2008-01-11 Impact factor: 2.300
Authors: Vikram Raghunathan; Patricia Liu; Tia C L Kohs; Ramin Amirsoltani; Michael Oakes; Owen J T McCarty; Sven R Olson; David Zonies; Joseph J Shatzel Journal: ASAIO J Date: 2021-08-01 Impact factor: 2.872