Key result
Preoperative AT activity, age, combined operation, diabetes, and CPB duration independently predicted antithrombin activity at the end of cardiopulmonary bypass (all p<0.05).
Why the study?
What factors determine the magnitude of antithrombin consumption during cardiac operations with cardiopulmonary bypass?
Observational (n=250)
What factors determine the magnitude of antithrombin consumption during cardiac operations with cardiopulmonary bypass?
Preoperative antithrombin activity, age, combined operation, diabetes, and cardiopulmonary bypass duration are independent predictors of antithrombin consumption during cardiac surgery.
May identify high-risk CPB patients for AT depletion; leaves open whether targeted repletion improves outcomes.
Antithrombin (AT) is a natural anticoagulant that is consumed during cardiac operations with cardiopulmonary bypass (CPB). This study is an observational trial aimed at identifying the factors determining the magnitude of the AT consumption during cardiac operations. Two hundred and fifty consecutive adult patients undergoing cardiac operations with CPB were admitted to the study. Preoperative and intraoperative variables were tested with respect to their role in determining AT activity at the end of the operation. At a univariate analysis, eight predictors of AT activity at the end of the operation have been identified: preoperative AT activity; age; diabetes on medication; preoperative haematocrit value; preoperative dialysis; combined operation; CPB duration; lowest temperature on CPB. A multivariate predictive model was created, and five factors remained as independent predictors of AT activity at the end of the operation: preoperative AT activity (p = 0.001); age (p = 0.015); combined operation (p = 0.014); diabetes (p = 0.013) and CPB duration (p = 0.001). On this basis, predictive tables of AT consumption have been established for different combinations of risk factors.
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Ranucci et al. (2004) conducted an observational in Cardiac operations requiring cardiopulmonary bypass (n=250). Patient and procedural risk factors was evaluated on Antithrombin activity at the end of the operation. Preoperative AT activity, age, combined operation, diabetes, and CPB duration independently predicted antithrombin activity at the end of cardiopulmonary bypass (all p<0.05).
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