Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Critical Care
Published in: Critical Care 6/2005

01-12-2005 | Commentary

Antithrombin in sepsis revisited

Author: Marcel Levi

Published in: Critical Care | Issue 6/2005

Login to get access

Abstract

As the pivotal phase III randomized controlled clinical trial on antithrombin concentrate in patients with severe sepsis did not show a beneficial effect of antithrombin treatment on 28-day mortality, the interest in the potential use of this treatment modality in sepsis has diminished. However, recent data on the effect of antithrombin administration on coagulation in combination with recent analyses from the clinical trials that were aimed to restore physiological anticoagulant pathways in patients with sepsis may revitalize the interest in antithrombin concentrate for the treatment of severe sepsis.
Literature
1.
Kountchev J, Bijuklic K, Bellmann R, Wiedermann CJ, Joannidis M: Reduction of D-dimer levels after therapeutic administration of antithrombin in acquired antithrombin deficiency of severe sepsis. Crit Care 2005, 9: R596-R600. 10.1186/cc3808PubMedCentralCrossRefPubMed
2.
Esmon CT: Role of coagulation inhibitors in inflammation. Thromb Haemost 2001, 86: 51-56.PubMed
3.
Levi M, de Jonge E, van der Poll T: Rationale for restoration of physiological anticoagulant pathways in patients with sepsis and disseminated intravascular coagulation. Crit Care Med 2001,29(Suppl 7):S90-94. 10.1097/00003246-200107001-00028CrossRefPubMed
4.
Mesters RM, Mannucci PM, Coppola R, Keller T, Ostermann H, Kienast J: Factor VIIa and antithrombin III activity during severe sepsis and septic shock in neutropenic patients. Blood 1996, 88: 881-886.PubMed
5.
Fourrier F, Chopin C, Goudemand J, Hendrycx S, Caron C, Rime A, Narey P, Lestavel P: Septic shock, multiple organ failure, and disseminated intravascular coagulation. Compared patterns of antithrombin III, protein C, and protein S deficiencies [see comments]. Chest 1992, 101: 816-823.CrossRefPubMed
6.
Minnema MC, Chang AC, Jansen PM, Lubbers YT, Pratt BM, Whittaker BG, Taylor FB, Hack CE, Friedman B: Recombinant human antithrombin III improves survival and attenuates inflammatory responses in baboons lethally challenged with Escherichia coli. Blood 2000, 95: 1117-1123.PubMed
7.
Levi M, van der Poll T, Buller HR: Bidirectional relation between inflammation and coagulation. Circulation 109: 2698-2704. 10.1161/01.CIR.0000131660.51520.9A
8.
Bernard GR, Vincent JL, Laterre PF, LaRosa SP, Dhainaut JF, Lopez-Rodriguez A, Steingrub JS, Garber GE, Helterbrand JD, Ely EW, Fisher CJ Jr, Recombinant human protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study group: Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 2001, 344: 699-709. 10.1056/NEJM200103083441001CrossRefPubMed
9.
Levi M, ten Cate H, van der Poll T: Disseminated intravascular coagulation: State of the art. Thromb Haemost 1999, 82: 695-705.PubMed
10.
Warren BL, Eid A, Singer P, Pillay SS, Carl P, Novak I, Chalupa P, Penzes I, Kubler A, Knaul S, et al.: Caring for the critically ill patient. High-dose antithrombin III in severe sepsis: a randomized controlled trial. J Am Med Assoc 2001, 286: 1869-1878. 10.1001/jama.286.15.1869CrossRef
11.
Blauhut B, Kramar H, Vinazzer H, Bergmann H: Substitution of antithrombin III in shock and DIC: a randomized study. Thromb Res 1985, 39: 81-89. 10.1016/0049-3848(85)90123-9CrossRefPubMed
12.
Bernard GR, Ely EW, Wright TJ, Stasek JE, Russell JA, Norris PE, Yau SB, Helterbrand JD: Safety and dose relationship of recombinant human activated protein C for coagulopathy in severe sepsis. Crit Care Med 2001, 29: 2051-2059. 10.1097/00003246-200111000-00003CrossRefPubMed
13.
Taylor FBJ, Toh CH, Hoots WK, Wada H, Levi M: Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost 2001, 86: 1327-1330.PubMed
14.
Dhainaut JF, Yan SB, Joyce DE, Petilla V, Busson BR, Brauelt JT, Saudin D, Levi M: Treatment effects of drotrecogin alfa (activated) in patients with severe sepsis with or without overt disseminated intravascular coagulation. J Thromb Haemost 2004, 2: 1924-1933. 10.1111/j.1538-7836.2004.00955.xCrossRefPubMed
Metadata
Title
Antithrombin in sepsis revisited
Author
Marcel Levi
Publication date
01-12-2005
Publisher
BioMed Central
Published in
Critical Care / Issue 6/2005
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc3819

Other articles of this Issue 6/2005

Critical Care 6/2005 Go to the issue

Research

The use of prophylactic fluconazole in immunocompetent high-risk surgical patients: a meta-analysis

Research

Mortality prediction using SAPS II: an update for French intensive care units

Commentary

Goal directed therapy: how long can we wait?

Commentary

The Surviving Sepsis Campaign sepsis change bundles and clinical practice

Research

Reduction of D-dimer levels after therapeutic administration of antithrombin in acquired antithrombin deficiency of severe sepsis

Research

Central venous catheter-related infection in a prospective and observational study of 2,595 catheters