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Antithrombin treatment in patients with traumatic brain injury: a pilot study
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
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2001 (English)In: J Neurosurg Anesthesiol, Vol. 13, no 1, 49-56 p.Article in journal (Refereed) Published
Abstract [en]

This study will determine if early administration of antithrombin concentrate to patients with traumatic brain injury (TBI) can inhibit or significantly shorten the time of coagulopathy. The progress of brain injury monitored by computed tomographic scan (CT) was also assessed, as was the time needed for intensive care and outcome related to Glasgow outcome scale (GOS). Twenty-eight patients with isolated brain trauma verified with CT were included in either of two parallel groups. The Glasgow coma score (GCS) was mean 7.5, and median 7.0; signifying a moderate to severe traumatic brain injury but with a mortality of only 3.5%. The patients randomized to antithrombin treatment received a total of 100 U/kg BW during 24 hours. To measure hypercoagulability, soluble fibrin (SF), D-dimer (D-d), and thrombin-antithrombin complex (TAT) were assessed together with antithrombin (AT) and routine coagulation tests. Before treatment, SF, D-d, and TAT were markedly increased in both groups. Soluble fibrin and D-dimer (measured after treatment began) appeared to decrease faster in the AT group, and there was a statistically significant difference between the groups at 36 hours for SF and at 36 hours, 48 hours, and at Day 3 for D-d. Thrombin-antithrombin complex levels were very high in both groups but, surprisingly, showed no significant difference between the groups. The authors conclude that antithrombin concentrate administered to patients with severe TBI resulted in a marginal reduction of hypercoagulation. We could not detect any obvious influence by antithrombin on brain injury progress, on CT, or on outcome or time needed for intensive care.

Place, publisher, year, edition, pages
2001. Vol. 13, no 1, 49-56 p.
Keyword [en]
Adolescent, Adult, Aged, Antithrombins/*therapeutic use, Blood Coagulation Tests, Brain Injuries/*drug therapy, Female, Glasgow Outcome Scale, Humans, Male, Middle Aged, Pilot Projects, Prospective Studies, Serine Proteinase Inhibitors/*therapeutic use
Identifiers
URN: urn:nbn:se:umu:diva-31426ISBN: 0898-4921 (Print) OAI: oai:DiVA.org:umu-31426DiVA: diva2:293001
Note

Grenander, A Bredbacka, S Rydvall, A Aroch, R Edner, G Koskinen, L O Olivecrona, M Clinical Trial Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't United States Journal of neurosurgical anesthesiology J Neurosurg Anesthesiol. 2001 Jan;13(1):49-56.

Available from: 2010-02-10 Created: 2010-02-10 Last updated: 2015-03-05

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Rydvall, A.Aroch, R.Koskinen, L. O.Olivecrona, M.

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