Supplementation therapy with Antithrombin Drugs in the Combined Treatment of Sepsis

Abstract

Purpose — to assess the efficacy of supplementation therapy for antithrombin deficiency in the combined treatment of sepsis.Materials and methods. A prospective-retrospective study of the efficacy of supplementation therapy for antithrombin deficiency during sepsis was carried out; 90 patients were examined. The patients were split into two groups whether antithrombin deficiency correction was or was not undertaken. The composite outcome — the incidence of cardiovascular complications as of day 28 from the therapy commencement — was chosen as the primary endpoint of the study. The secondary endpoints of the study were prevalence of adverse events as of day 28 from the therapy commencement and 180-day mortality.Results. There was no difference between the groups either in respect of 28-day mortality or composite outcome. Analysis of secondary endpoints revealed that in the group of patients who received antithrombin supplementation therapy, the risk of development of an acute renal injury was significantly lower on day 28 and 180 from therapy commencement: OR 3.5 [95% CI 1.05–11.66] at P=0.04 and OR 2.92 [95% CI 1.02–8.31] at P=0.045, respectively.Conclusion. Correction of antithrombin level to activity level ‘over 61%’ is associated with decreased incidence degree III acute kidney failure (KDIGO).

Keywords

• сепсис
• заместительная терапия
• антитромбин
• острая почечная недостаточность