Intensive Care Medicine

, Volume 24, Issue 4, pp 336–342 | Cite as

Antithrombin III (ATILL) replacement therapy in patients with sepsis and/or postsurgical complications: a controlled double-blind, randomized, multicenter study

  • F. Baudo
  • T. M. Caimi
  • F. deCataldo
  • A. Ravizza
  • S. Arlati
  • G. Casella
  • D. Carugo
  • G. Palareti
  • C. Legnani
  • L. Ridolfi
  • R. Rossi
  • A. D’Angelo
  • L. Crippa
  • D. Giudici
  • G. Gallioli
  • A. Wolfler
  • G. Calori
Original

Abstract

Background: ATIII is decreased in sepsis and/or shock and its baseline value correlates with mortality. The efficacy of ATIII therapy on mortality was assessed in a selected group of patients admitted to the intensive care unit (ICU) in a double-blind, randomized, multicenter study.

Methods: 120 patients admitted to the ICU with an ATIII concentration < 70% were randomized to receive ATIII (total dose 24000 units) or placebo treatment for 5 days; 56 patients had septic shock.

Results: ATIII concentrations in the treated group remained constant throughout the treatment period (range 97–102%). The Kaplan-Meier analysis showed no difference in overall survival between the two groups: 50 and 46 % for ATIII and placebo, respectively. Septic shock and hemodynamic support were unbalanced in the two groups at admission. Therefore the Cox analysis was carried out after adjusting for these two variables. Treatment with ATIII decreases the risk of death with an odds ratio (OR) of 0.56. Of the covariates analyzed, septic shock and the baseline multiple organ failure score were negatively associated with survival and plasma activity level was positively associated with survival with an OR of 0.97 for each 1 % increase in the ATIII plasma concentration at baseline.

Conclusions: The results of ATIII treatment in this population of patients suggests that replacement therapy reduces mortality in the subgroup of septic shock patients only.

Keywords

Acquired ATIII deficiency ATIII replacement therapy Septic shock 

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Copyright information

© Springer-Verlag 1998

Authors and Affiliations

  • F. Baudo
    • 1
  • T. M. Caimi
    • 1
  • F. deCataldo
    • 1
  • A. Ravizza
    • 2
  • S. Arlati
    • 2
  • G. Casella
    • 2
  • D. Carugo
    • 2
  • G. Palareti
    • 3
  • C. Legnani
    • 3
  • L. Ridolfi
    • 4
  • R. Rossi
    • 4
  • A. D’Angelo
    • 5
  • L. Crippa
    • 5
  • D. Giudici
    • 6
  • G. Gallioli
    • 6
  • A. Wolfler
    • 6
  • G. Calori
    • 7
  1. 1.Department of Hematology, Hemostasis and Thrombosis UnitOspedale NiguardaMilanoItaly
  2. 2.Department of Intensive CareOspedale NiguardaMilanoItaly
  3. 3.Department of AngiologyOspedale S. OrsolaBolognaItaly
  4. 4.Department of Intensive CareOspedale S. OrsolaBolognaItaly
  5. 5.Hemostasis LaboratoryOspedale S. RaffaeleMilanoItaly
  6. 6.Intensive Care UnitOspedale S. RaffaeleMilanoItaly
  7. 7.Epidemiology UnitOspedale S. RaffaeleMilanoItaly

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