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Evaluation of a mathematical model for blood gases and acid–base status during extracorporeal circulation.doc

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Evaluation of a mathematical model for blood gases and acid–base status during extracorporeal circulation

Available online /supplements/7/S1 Critical Care Volume 7 Supplement 1, 2003 Abstracts of the 4th International Symposium on the Pathophysiology of Cardiopulmonary Bypass: Endothelial Damage Munich, Germany, 29 November 2002 Received: 15 January 2003 Published online: 18 February 2003 This article is online at /supplements/7/S1 ? 2003 BioMed Central Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) 1 Antithrombin substitution before extracorporeal circulation attenuates perioperative coagulation activation and might decrease postoperative troponin elevation: a report of preliminary data R Busley1, W Dietrich1, S Braun2, J Weipert3, JA Richter1 Departments of 1Anesthesiology, 2Laboratory Medicine and 3Cardiac Surgery, German Heart Center Munich, Germany (e-mail: r.busley@lrz.tum.de) Critical Care 2003, 7 (Suppl 1):1 (DOI 10.1186/cc2147) Objectives Antithrombin (AT) has been proven to have major impact on perioperative activation of the coagulation system. The aim of this prospective, controlled, single-blind clinical trial was to determine the impact of AT substitution on perioperative thrombin formation. Figure 1 1.2 1.0 0.8 A B C D Methods Forty male coronary artery bypass graft patients partici- pated in the trial. Prior to skin incision, 30 patients received AT according to a formula targeted at 120% AT activity before extracor- poreal circulation (ECC), plus an additional 1000 U (group A, n = 10), 2000 U (group B, n = 10) or 3000 U (group C, n = 10) of AT in order to compensate for increased consumption during ECC. Control patients did not receive any AT substitution (group D, n = 10). The fol- lowing parameters were determined perioperatively and until the fifth postoperative day: AT levels, parameters of coagulation activation (prothrombin fragment F1.2, thrombin–antithrombin complex, D-dimer), inflammation (IL-6) and myocardial perfusion (troponin). Statistical comparison between groups was performed using analysis