Antithrombin and hypercoagulability in sepsis: insights from thrombelastography?

doi:10.1186/cc5156

Critical Care
Volume 11
Issue 1

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Commentary

Antithrombin and hypercoagulability in sepsis: insights from thrombelastography?

Johannes N Hoffmann and Kerstin Schick

Department of Surgery, University of Munich, Großhadern, Marchioninistr., 81377 München, Germany

author email corresponding author email

Critical Care 2007, 11:115doi:10.1186/cc5156


Published:	23 February 2007

See related research by Gonano et al., http://ccforum.com/content/10/6/R160 and related letter by Puana and Nates, http://ccforum.com/content/11/2/409

Abstract

Antithrombin (AT) has been used for over 25 years to successfully treat disseminated intravascular coagulation (DIC). A four-day AT therapy in patients with DIC in the KyberSept trial has been related to a clear survival benefit in patients not receiving concomitant heparin. Gonano and coworkers performed thrombelastography (TEG) measurements in patients with severe sepsis and clearly showed hypercoagulability, as defined by five TEG parameters, compared to healthy controls. In the AT group they found a trend towards normalization of TEG parameters after treatment, although this did not reach statistical significance. This first clinical evaluation of hypercoagulability during AT treatment could not provide evidence for an attenuation of coagulopathy, an effect that might be due to high inter-individual variability.