Abstract
Hemorrhage, head injury, and multiple organ dysfunction are the most frequent causes of mortality in patients who experience severe injury. Acceleration of the coagulation cascade is known to result in hemorrhage secondary to disseminated intravascular coagulation (DIC) and end-organ dysfunction, as manifest by pulmonary and renal failure. Few studies have been conducted to evaluate the effects of injury on the endogenous anticoagulants that inhibit excessive coagulation activation. We evaluated a group of patients following severe injury and found that procoagulant markers (prothrombin fragment 1.2, thrombin antithrombin complexes, and D dimers) were significantly elevated for the population as a whole. Levels of circulating endogenous anticoagulants [antithrombin (AT) and protein C] were relatively unchanged for the total population. However, patients with adverse outcomes [DIC and adult respiratory distress syndrome (ARDS)] had significant reductions in AT and protein C activities. Decreased levels of AT and protein C 8 hours after admission served as independent predictors of both DIC and ARDS. Prospective, randomized studies should be conducted to evaluate the effect of supplementation of these factors after severe injury has occurred.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 17-24 |
| Number of pages | 8 |
| Journal | Seminars in Thrombosis and Hemostasis |
| Volume | 23 |
| Issue number | SUPPL. 1 |
| State | Published - 1997 |
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Keywords
- adult respiratory distress syndrome (ARDS)
- Antithrombin (AT)
- deep venous thrombosis (DVT)
- disseminated intravascular coagulation (DIC)
- trauma
ASJC Scopus subject areas
- Hematology
Cite this
Acquired antithrombin deficiency following severe traumatic injury : Rationale for study of antithrombin supplementation. / Owings, John T; Gosselin, Robert.
In: Seminars in Thrombosis and Hemostasis, Vol. 23, No. SUPPL. 1, 1997, p. 17-24.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Acquired antithrombin deficiency following severe traumatic injury
T2 - Rationale for study of antithrombin supplementation
AU - Owings, John T
AU - Gosselin, Robert
PY - 1997
Y1 - 1997
N2 - Hemorrhage, head injury, and multiple organ dysfunction are the most frequent causes of mortality in patients who experience severe injury. Acceleration of the coagulation cascade is known to result in hemorrhage secondary to disseminated intravascular coagulation (DIC) and end-organ dysfunction, as manifest by pulmonary and renal failure. Few studies have been conducted to evaluate the effects of injury on the endogenous anticoagulants that inhibit excessive coagulation activation. We evaluated a group of patients following severe injury and found that procoagulant markers (prothrombin fragment 1.2, thrombin antithrombin complexes, and D dimers) were significantly elevated for the population as a whole. Levels of circulating endogenous anticoagulants [antithrombin (AT) and protein C] were relatively unchanged for the total population. However, patients with adverse outcomes [DIC and adult respiratory distress syndrome (ARDS)] had significant reductions in AT and protein C activities. Decreased levels of AT and protein C 8 hours after admission served as independent predictors of both DIC and ARDS. Prospective, randomized studies should be conducted to evaluate the effect of supplementation of these factors after severe injury has occurred.
AB - Hemorrhage, head injury, and multiple organ dysfunction are the most frequent causes of mortality in patients who experience severe injury. Acceleration of the coagulation cascade is known to result in hemorrhage secondary to disseminated intravascular coagulation (DIC) and end-organ dysfunction, as manifest by pulmonary and renal failure. Few studies have been conducted to evaluate the effects of injury on the endogenous anticoagulants that inhibit excessive coagulation activation. We evaluated a group of patients following severe injury and found that procoagulant markers (prothrombin fragment 1.2, thrombin antithrombin complexes, and D dimers) were significantly elevated for the population as a whole. Levels of circulating endogenous anticoagulants [antithrombin (AT) and protein C] were relatively unchanged for the total population. However, patients with adverse outcomes [DIC and adult respiratory distress syndrome (ARDS)] had significant reductions in AT and protein C activities. Decreased levels of AT and protein C 8 hours after admission served as independent predictors of both DIC and ARDS. Prospective, randomized studies should be conducted to evaluate the effect of supplementation of these factors after severe injury has occurred.
KW - adult respiratory distress syndrome (ARDS)
KW - Antithrombin (AT)
KW - deep venous thrombosis (DVT)
KW - disseminated intravascular coagulation (DIC)
KW - trauma
UR - http://www.scopus.com/inward/record.url?scp=0031006808&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031006808&partnerID=8YFLogxK
M3 - Article
C2 - 9156418
AN - SCOPUS:0031006808
VL - 23
SP - 17
EP - 24
JO - Seminars in Thrombosis and Hemostasis
JF - Seminars in Thrombosis and Hemostasis
SN - 0094-6176
IS - SUPPL. 1
ER -