Abstract
Objectives: We assessed the combination effect of use of genetic recombinant human soluble thrombomodulin (rTM) with antithrombin (AT) in the treatment of sepsis-induced disseminated intravascular coagulation (DIC) after conducting surgical interventions. Methods: We performed a retrospective analysis of septic shock patients admitted to our intensive care unit between August 2008 and February 2012 who were diagnosed as having DIC. The patients underwent surgical interventions for infection. The patients with sepsis who met the diagnostic criteria for acute DIC (JAAM) and showed an AT level of less than 70% were treated with AT products (AT group). The septic DIC patients treated with rTM in addition to the above treatment were designated as the AT+rTM group. Differences between the AT and AT+rTM groups were investigated to determine the effect of rTM by evaluating the clinical course according to the hemostatic markers and organ dysfunction during the treatment and the outcomes of the patients at 60 days. Results: The AT group and the AT+rTM group comprised 10 patients each. There were no significant differences in clinical characteristics and laboratory data except for AT activity on admission between the two groups. SOFA score, P/F ratio and the change of platelet count, FDP, and AT activity on the 3rd, 5th, and 7th days were not significantly different between the two groups. All patients in both groups survived 60 days after admission, and length of ICU stay, mechanical ventilation time, and continuous hemodiafiltration time over the period of observation were not significantly different between the two groups. Conclusion: Generally, treatment for septic DIC is directed towards the underlying problem or inciting cause. Early rTM treatment combined with AT after surgical intervention did not appear to be an influential strategy for the management of septic DIC.
