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Antithrombin III
The Experts below are selected from a list of 99 Experts worldwide ranked by ideXlab platform
Hiromi Kurosawa – 1st expert on this subject based on the ideXlab platform
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heparin and Antithrombin III levels during cardiopulmonary bypass correlation with subclinical plasma coagulation
The Annals of Thoracic Surgery, 1994Co-Authors: Kazuhiro Hashimoto, Masaaki Yamagishi, Tatsuumi Sasaki, M Nakano, Hiromi KurosawaAbstract:Abstract The anticoagulant effect of heparin in the milieu of altered Antithrombin III levels was investigated in adult (n = 7) and pediatric (n = 14) patients undergoing open heart operations. The pediatric patients were subdivided into a control group (n = 8) and an Antithrombin III group (n = 6), which received 1,000 units of Antithrombin III. The reduction in Antithrombin III levels during Cardiopulmonary bypass was obvious in patients of all ages, showing a greater reduction (although not statistically significant) in the pediatric patients. However, the Antithrombin III group patients maintained their preoperative levels of Antithrombin III. The elevated fibrinopeptide A levels in pediatric and adult control group patients suggested that considerable subclinical plasma coagulation occurred during open heart operations, especially during the normothermic period of cardiopulmonary bypass and after the administration of protamine. Antithrombin III levels in the children were the most predictive (r = −0.58; p p
George J Despotis – 2nd expert on this subject based on the ideXlab platform
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Antithrombin III concentrate to treat heparin resistance in patients undergoing cardiac surgery
The Journal of Thoracic and Cardiovascular Surgery, 2002Co-Authors: John H Lemmer, George J DespotisAbstract:Abstract Objective: The purpose of this report is to describe the clinical use of Antithrombin III concentrate in 53 patients who were found, in the operating room before cardiopulmonary bypass, to be heparin resistant. Method: Resistance to heparin was determined to be present when greater than 600 U/kg body weight of heparin failed to prolong the kaolin-activated clotting time to more than 600 seconds in 53 aprotinin-treated patients. Blood samples were obtained for subsequent Antithrombin III activity determination. Patients were then administered 500 U of Antithrombin III concentrate, and the activated clotting time was remeasured. If the activated clotting time remained less than 600 seconds, a second 500-U dose was given. Results: Of the 53 patients, 45 (85%) had subnormal measured Antithrombin III activity, and the mean plasma Antithrombin III activity level for the entire group was 67% (normal 80%-120%). Administration of Antithrombin III concentrate (500 U in 45 patients and 1000 U in 8 patients) resulted in prolongation of the mean activated clotting time from 492 to 789 seconds without additional heparin. The mean heparin dose response increased from 36.5 to 69.3 s·U –1 ·mL –1 with Antithrombin III treatment. Only one patient did not achieve the target activated clotting time, despite administration of greater than 600 U/kg heparin and 1000 U of Antithrombin III concentrate, and was treated with fresh-frozen plasma. Conclusions: On the basis of the criterion used in this report, most of the patients defined as being heparin resistant had subnormal plasma Antithrombin III activity. Treatment with Antithrombin III concentrate resulted in potentiation of the heparin effect to meet predetermined activated clotting time thresholds and allow for cardiopulmonary bypass.
Kazuhiro Hashimoto – 3rd expert on this subject based on the ideXlab platform
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heparin and Antithrombin III levels during cardiopulmonary bypass correlation with subclinical plasma coagulation
The Annals of Thoracic Surgery, 1994Co-Authors: Kazuhiro Hashimoto, Masaaki Yamagishi, Tatsuumi Sasaki, M Nakano, Hiromi KurosawaAbstract:Abstract The anticoagulant effect of heparin in the milieu of altered Antithrombin III levels was investigated in adult (n = 7) and pediatric (n = 14) patients undergoing open heart operations. The pediatric patients were subdivided into a control group (n = 8) and an Antithrombin III group (n = 6), which received 1,000 units of Antithrombin III. The reduction in Antithrombin III levels during Cardiopulmonary bypass was obvious in patients of all ages, showing a greater reduction (although not statistically significant) in the pediatric patients. However, the Antithrombin III group patients maintained their preoperative levels of Antithrombin III. The elevated fibrinopeptide A levels in pediatric and adult control group patients suggested that considerable subclinical plasma coagulation occurred during open heart operations, especially during the normothermic period of cardiopulmonary bypass and after the administration of protamine. Antithrombin III levels in the children were the most predictive (r = −0.58; p p