We have located links that may give you full text access.
Journal Article
Review
Clinical trial results with antithrombin III in sepsis.
Critical Care Medicine 2000 September
OBJECTIVE: To present and discuss the rationale and results of clinical trials using antithrombin (AT) supplementation in patients with sepsis.
DATA SOURCES/STUDY SELECTION: Review of all controlled (open or double-blind) studies of patients with severe sepsis or septic shock who were treated with AT concentrates to obtain better control of coagulation activation and inflammation.
DATA EXTRACTION: AT is a major inhibitor of the coagulation cascade. Recent experimental studies have also shown that it can modulate the inflammatory reactions that occur during sepsis. An early and prolonged decrease in AT activity is well documented during sepsis-induced disseminated intravascular coagulation and during the systemic inflammatory response. Thus, supplementation with AT concentrates has been proposed as a potential therapy in sepsis patients.
DATA SYNTHESIS: Numerous uncontrolled studies of AT supplementation in sepsis patients have been reported in the last 20 yrs. Since 1993, four placebo-controlled randomized studies have been performed in France, Germany, Northwestern Europe, and Italy. Three of these studies were subjected to a meta-analysis of 122 patients. Results showed a nonsignificant 22% reduction in the 30-day all-cause mortality and a reduction in the length of stay in the intensive care unit in the AT treated group. The Italian study of 120 patients demonstrated that the overall mortality was similar in the placebo and treated groups. However, post hoc analysis according to the Cox regression model showed that in patients with septic shock, AT supplementation significantly decreased the risk of death.
CONCLUSIONS: Together, these studies are consistent with the positive effect seen with AT supplementation in patients with severe sepsis. A multicenter phase III trial is currently in progress to definitively document its effect on mortality.
DATA SOURCES/STUDY SELECTION: Review of all controlled (open or double-blind) studies of patients with severe sepsis or septic shock who were treated with AT concentrates to obtain better control of coagulation activation and inflammation.
DATA EXTRACTION: AT is a major inhibitor of the coagulation cascade. Recent experimental studies have also shown that it can modulate the inflammatory reactions that occur during sepsis. An early and prolonged decrease in AT activity is well documented during sepsis-induced disseminated intravascular coagulation and during the systemic inflammatory response. Thus, supplementation with AT concentrates has been proposed as a potential therapy in sepsis patients.
DATA SYNTHESIS: Numerous uncontrolled studies of AT supplementation in sepsis patients have been reported in the last 20 yrs. Since 1993, four placebo-controlled randomized studies have been performed in France, Germany, Northwestern Europe, and Italy. Three of these studies were subjected to a meta-analysis of 122 patients. Results showed a nonsignificant 22% reduction in the 30-day all-cause mortality and a reduction in the length of stay in the intensive care unit in the AT treated group. The Italian study of 120 patients demonstrated that the overall mortality was similar in the placebo and treated groups. However, post hoc analysis according to the Cox regression model showed that in patients with septic shock, AT supplementation significantly decreased the risk of death.
CONCLUSIONS: Together, these studies are consistent with the positive effect seen with AT supplementation in patients with severe sepsis. A multicenter phase III trial is currently in progress to definitively document its effect on mortality.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app