25% Albumin Infusion Maintains Antithrombin III (AT) Activity after AT Agent Administration in Critically Ill Patients with Disseminated Intravascular Coagulation (DIC)
- *Corresponding Author:
- Aibiki M
Department of Emergency and Critical Care Medicine, Ehime University
Graduate School of Medicine, 454 Shitsukawa
Tohon, Ehime, 791-0295, Japan
E-mail: [email protected]
Received date: February 15, 2014; Accepted date: March 31, 2014; Published date: April 08, 2014
Citation: Aibiki M, Fukuoka N, Bando S, Matsumoto H, Ohshita M, et al. (2014) 25% Albumin Infusion Maintains Antithrombin III (AT) Activity after AT Agent Administration in Critically Ill Patients with Disseminated Intravascular Coagulation (DIC). J Blood Disord Transfus 5: 210. doi:10.4172/2155-9864.1000208
Copyright: © 2014 Aibiki M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: To report for the first time critically ill patients with disseminated intravascular coagulation (DIC) in whom the infusion of 25% albumin solution produces remarkable elevations in plasma antithrombin III (AT) activities after administration of AT agents.
Design: A prospective observational study. Interventions: 1) Plasma AT activities were serially measured in DIC patients after AT administration, enable us to analyze their pharmacokinetics; 2) Comparisons of AT activities between two groups of receiving AT agent with or without the infusion of 25% albumin solution; 3) in vitro examinations were conducted to define whether albumin application itself would influence directly an AT measurement system using samples already determined the levels of AT activities.
Methods and main results: Twenty consecutive critical patients with DIC were divided into two groups: groups receiving AT agents of 1500 units with (N=11) and without (N=9) the application of 25% albumin solutions. Patients treated with albumin solutions after AT agents showed remarkable elevations in AT peak and trough activities, whereas patients receiving the same dose of the AT agents without albumin co-administration did not maintain its trough activity. Pharmacokinetic analyses revealed that patients had shortened the distribution half-life time of AT, suggesting enhanced vascular permeability. The levels of AT activities in patients treated with both albumin and AT agents (N=11) were significantly higher than those without albumin administration (N=9, p=0.01). Furthermore, in vitro albumin applications to the AT measurement system did not effect on its values in the samples.
Conclusion: This is the first report indicating that 25% albumin administration could elevate and sustain AT activities, even when a limited AT dose was administered to DIC patients with increased vascular permeability. This may be due to a certain binding effect of albumin, which needs to be defined in the future.