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Antithrombin level and circuit thrombosis during hemofiltration after cardiopulmonary bypass

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Abstract

Objective

Hemofilter thrombosis occurs frequently during continuous veno-venous hemofiltration in intensive care units. Among coagulation disorders, antithrombin deficiency has been shown to be linked to hemofilter thrombosis. We investigated whether there was an association between antithrombin level activity and hemofilter thrombosis occurrence during early continuous hemofiltration following cardiopulmonary bypass.

Design

Prospective observational study.

Setting

Intensive care unit in University Teaching Hospital.

Patients and participants

Forty-eight consecutive patients.

Measurements and results

Antithrombin level activity was measured just before the start of hemofiltration, and repeated at 24 h intervals for a total of 3 days. Hemofilter thrombosis episodes were recorded at each 24-h interval following antithrombin level activity measurement. Subjects were classified as HT when one or more episodes of hemofilter thrombosis appeared in this period and NHT if none. Morbidity parameters and mortality were recorded. Mean initial antithrombin level activity was low and not different in HT and NHT groups at day 0 (60.6 ± 20.9% vs. 63.4 ± 19.9%, P = 0.68). Antithrombin level activity was lower at day 1 (47.2 ± 12.0% vs. 58.2 ± 15.2%, P = 0.03) and day 2 (41.2 ± 15.3% vs. 53.5 ± 14.1%, P = 0.04) in HT group. However, antithrombin level activity was not shown to be predictive of HT in multivariate analysis. Morbidity and mortality did not differ significantly between the two groups.

Conclusion

Only a weak association was found between antithrombin level activity and HT during early veno-venous hemofiltration post-cardiopulmonary bypass. This result was not confirmed in multivariate analysis.

Descriptor

Renal failure: dialysis and hemofiltration.

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Acknowledgments

We thank Pr Ingrand for statistical expertise.

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Authors and Affiliations

  1. Département d’anesthésie réanimation, CHU Poitiers, Poitiers cedex, France

    H. Lanquetot & T. Leprince

  2. Service d’hématologie et oncologie biologique, CHU Poitiers, Poitiers cedex, France

    C. Boinot

  3. Centre d’Investigation Clinique INSERM 802, CHU Poitiers, Poitiers cedex, France

    S. Ragot

  4. Département de chirurgie cardio thoracique, CHU Poitiers, Poitiers cedex, France

    C. Jayle

  5. Service de réanimation médicale, 2 rue de la Milétrie, BP577, 86021, Poitiers cedex, France

    R. Robert

  6. Inserm, U927, 86021, Poitiers, France

    L. Macchi

  7. Faculté de Médecine et Pharmacie, Université de Poitiers, 34 rue du jardin des Plantes, 86021, Poitiers cedex, France

    S. Ragot, C. Boinot & L. Macchi

  8. INSERM ERM 324, Faculté de Médecine et Pharmacie, CHU Poitiers Hôpital La Milétrie, Poitiers, France

    L. Macchi

Authors
  1. H. Lanquetot
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  2. T. Leprince
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  3. S. Ragot
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  4. C. Boinot
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  5. C. Jayle
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  6. R. Robert
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  7. L. Macchi
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Corresponding author

Correspondence to L. Macchi.

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Lanquetot, H., Leprince, T., Ragot, S. et al. Antithrombin level and circuit thrombosis during hemofiltration after cardiopulmonary bypass. Intensive Care Med 34, 2068–2075 (2008). https://doi.org/10.1007/s00134-008-1181-x

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  • DOI: https://doi.org/10.1007/s00134-008-1181-x

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