Antithrombin(H) concentrate infusions are safe and effective in patients with thermal injuries

An antithrombin (AT) deficiency develops in patients with thermal injuries as a result of the subclinical disseminated intravascular coagulation. We c onducted a pilot study to assess AT(Human [H]) concentrate infusions for sa fety and efficacy in thermal injury. Nine patients with burns who received Thrombate (Bayer Corporation, Berkeley, Calif) AT(H) concentrate infusions every 8 hours to raise the plasma level to 175% in the first 72 hours after injury were compared with 9 control patients with burns. Admission AT plas ma levels were 45% +/- 10% in patients treated with AT(H) versus 49% +/- 18 % in control patients (normal, 100% +/- 20%). Day-2 to day-4 levels were 12 0% +/- 25% in patients treated with AT(H) patients versus 50% +/- 12% in th e control patients (P < .002). In the group treated with AT(H), the time to wound healing was shorter for all body regions and was significantly short er for the hand (P < .02). Compared with control patients, patients treated with AT(H) had similar blood loss per grafted area. A trend toward fewer a utografting procedures, a shorter meshed autograft healing time, and a decr eased hospital stay was found for the patients treated with AT(H). AT(H) co ncentrate infusions are safe with thermal injury and are a viable option to shorten the length of hospitalization and to promote graft viability and s urvival. Clinical trials to confirm the benefit of this medication in the a cute phase of thermal injury would be worthwhile.