Effects of combination therapy using antithrombin and thrombomodulin for sepsis-associated disseminated intravascular coagulation

Annals of Intensive Care
Toshiaki IbaSatoshi Gando

Abstract

No single anticoagulant has been proven effective for sepsis-associated disseminated intravascular coagulation (DIC). Thus, the concomitant use of antithrombin concentrate and recombinant thrombomodulin has been conceived. This observational study was conducted to investigate the efficacy and safety of this combination therapy. A total of 510 septic DIC patients who received antithrombin substitution were retrospectively analyzed. Among them, 228 were treated with antithrombin and recombinant thrombomodulin (combination therapy) and the rest were treated with antithrombin alone (monotherapy). Propensity score matching created 129 matched pairs, and 28-day all-cause mortality, DIC scores, the sequential organ failure assessment (SOFA) scores, and the incidence of bleeding were compared. A log-rank test revealed a significant association between combination therapy and a lower 28-day mortality rate (hazard ratio 0.49, 95% confidence interval 0.29-0.82, P = 0.006) in the matched pairs. The DIC scores and the SOFA scores in the combination therapy group were significantly lower than those in the monotherapy group on Day 4 and Day 7. The incidence of bleeding did not differ between the groups (2.11 vs. 2.31%, P = 1.000). The current...Continue Reading

References

Apr 21, 2005·The Journal of Clinical Investigation·Kazuhiro AbeyamaIkuro Maruyama
Mar 8, 2006·Critical Care Medicine·Satoshi GandoUNKNOWN Japanese Association for Acute Medicine Disseminated Intravascular Coagulation (JAAM DIC) Study Group
Mar 18, 2006·Critical Care : the Official Journal of the Critical Care Forum·Christian J Wiedermann
Sep 29, 2009·Thrombosis Research·Hideo WadaUNKNOWN Japanese Society of Thrombosis Hemostasis/DIC subcommittee
Dec 17, 2009·Critical Care : the Official Journal of the Critical Care Forum·Toshiaki IbaYoichi Ohno
Sep 21, 2011·Thrombosis Research·Marcello Di NisioUNKNOWN Italian Society for Thrombosis and Haemostasis
Sep 16, 2014·Critical Care : the Official Journal of the Critical Care Forum·Toshiaki IbaHidesaku Asakura
Jan 13, 2015·Journal of Thrombosis and Haemostasis : JTH·K YamakawaT Shimazu
Mar 5, 2015·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Atsuhiko MurataShinya Matsuda
Apr 18, 2015·Critical Care : the Official Journal of the Critical Care Forum·Jumpei YoshimuraTakeshi Shimazu
Mar 5, 2016·Thrombosis and Haemostasis·Mineji HayakawaUNKNOWN Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study group
May 11, 2016·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Toshiaki IbaYasuhiro Kuroda
Jan 19, 2017·Critical Care Medicine·Andrew RhodesR Phillip Dellinger

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Citations

Apr 14, 2018·Critical Care Medicine·Garrett W BrittonChristopher J Colombo
Nov 30, 2018·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Katsunori MochizukiHiroshi Imamura
Mar 7, 2019·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Hiroyuki NagafuchiToshiaki Ikeda
May 1, 2020·Italian Journal of Pediatrics·Hayato GoMitsuaki Hosoya
Mar 5, 2019·British Journal of Haematology·Marie Scully, Marcel Levi
Feb 28, 2019·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Toshiaki IbaJerrold H Levy

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