Postoperative antithrombin levels and outcome in cardiac operations

Marco Ranucci, Alessandro Frigiola, Lorenzo Menicanti, Antonio Ditta, Alessandra Boncilli, Simonetta Brozzi

Research output: Contribution to journalArticlepeer-review

Abstract

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

Original languageEnglish
Pages (from-to)355-360
Number of pages6
JournalCritical Care Medicine
Volume33
Issue number2
DOIs
Publication statusPublished - Feb 2005

Keywords

  • Anticoagulants
  • Antithrombin
  • Cardiopulmonary bypass
  • Complications
  • Surgery

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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