Tags Archives: Antithrombin

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Hereditary Antithrombin Deficiency in Pediatric Patients: Pathophysiology, Clinical Features, Diagnosis, and Antithrombin Replacement Therapy

Abstract Antithrombin (AT), a glycoprotein, plays a key role in anticoagulation by inhibiting coagulation proteases. It is also the primary mediator of heparin's anticoagulant effect, with heparin binding amplifying AT..

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Combined Antithrombin and Heparin Supplementation to Blood for Restoring Heparin Responsiveness After Andexanet Alfa Exposure: An In Vitro Model

Abstract Background: Andexanet alfa, a Gla-domainless mutant factor Xa (GDXa), reverses oral FXa inhibitors but can cause severe heparin resistance during cardiopulmonary bypass (CPB). Antithrombin (AT) supplementation may mitigate this..

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Antithrombin Supplementation in Extracorporeal Membrane Oxygenation: A Systematic Review With Meta-Analysis

Abstract Background The Extracorporeal Life Support Organization recommends daily antithrombin monitoring and supplementation to achieve > 50%–80% activity during extracorporeal membrane oxygenation (ECMO). Evidence supporting this practice is uncertain, and whether..

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Analysis of Risk Factors for Heparin Resistance During Cardiac Surgery: Does Antithrombin Deficiency Cause Heparin Resistance?

Abstract Objectives To determine whether heparin resistance (HR) occurring during  (CPB) is associated with  (antithrombin III) activity. Design Retrospective review of data collected prospectively in a single center. Setting A tertiary referral..

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Development of Experimental Models of Antithrombin-independent Heparin Resistance Using Platelet Factor 4 and the Effect of Antithrombin in These Models

Abstract Objectives Antithrombin (AT) deficiency is considered the primary cause of heparin resistance (HR); however, some patients with HR have normal AT activity (AT-independent HR). Supplementation with concentrated human AT..

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Investigation of the impact of antithrombin deficiency on the inflammatory response: Results from a single centre cohort study

Abstract Background Antithrombin signalling may exert an anti-inflammatory effect; therefore we hypothesised that individuals with inherited antithrombin deficiency (ATD) may have an altered inflammatory state. Aims To assess the inflammatory..

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Antithrombin Levels and Heparin Responsiveness during Venoarterial Extracorporeal Membrane Oxygenation: A Prospective Single-center Cohort Study

Abstract Background Unfractionated heparin, administered during venoarterial extracorporeal membrane oxygenation to prevent thromboembolic events, largely depends on plasma antithrombin for its antithrombotic effects. Decreased heparin responsiveness seems frequent on extracorporeal..

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Acquired antithrombin deficiency in adult patients with postcardiotomy extracorporeal membrane oxygenation

Abstract Introduction This study aimed to investigate the relationship between acquired antithrombin deficiency in patients undergoing postcardiotomy extracorporeal membrane oxygenation (PC-ECMO) and thromboembolic or haemorrhagic events such as bleeding, peripheral..

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Heparin-Bead Extraction Enhanced Fluorogenic Aptamer–Thrombin Composite Reporter Enables Sensitive and Rapid Detection of Functional Antithrombin

Abstract Antithrombin (AT) deficiency in the extracorporeal circulation during cardiac surgery leads to uncontrolled inflammation and vascular damage in patients. AT levels decrease in sepsis, major trauma, extracorporeal membrane oxygenation,..

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Heparin-Bead Extraction Enhanced Fluorogenic Aptamer–Thrombin Composite Reporter Enables Sensitive and Rapid Detection of Functional Antithrombin

Abstract Antithrombin (AT) deficiency in the extracorporeal circulation during cardiac surgery leads to uncontrolled inflammation and vascular damage in patients. AT levels decrease in sepsis, major trauma, extracorporeal membrane oxygenation,..

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Antithrombin during veno-venous extracorporeal membrane oxygenation with heparin anticoagulation: A single-center cohort study

Abstract Introduction Antithrombin (AT) is a natural anticoagulant essential to enhancing the unfractionated heparin (UFH) anticoagulant effect. Its supplementation in the management of UFH-based anticoagulation during veno-venous extracorporeal membrane oxygenation..

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Antithrombin restriction in extracorporeal membrane oxygenation support (ARES): A multidisciplinary approach

Abstract Background:   Antithrombin (AT) replacement is occasionally utilized in the setting of extracorporeal membrane oxygenation (ECMO)-associated heparin resistance. Although past studies emphasized the high costs and limited clinical benefit..

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Antithrombin Levels and Heparin Responsiveness during Venoarterial Extracorporeal Membrane Oxygenation: A Prospective Single-center Cohort Study

Abstract Unfractionated heparin, administered during venoarterial extracorporeal membrane oxygenation to prevent thromboembolic events, largely depends on plasma antithrombin for its antithrombotic effects. Decreased heparin responsiveness seems frequent on extracorporeal membrane..

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The effect of perioperative antithrombin supplementation on blood conservation and postoperative complications after cardiopulmonary bypass surgery: A systematic review, meta-analysis…

Abstract Study objective  (AT) activity is reduced during  (CPB) surgery. Guidelines has demonstrated that perioperative AT supplementation contributed to blood conservation and prevent perioperative  complications and target organ injury owing to its..

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Antithrombin concentrates may benefit cardiopulmonary bypass patients with suspected heparin resistance: A retrospective analysis of real-world data

Abstract Background Heparin resistance is a common complication of surgical patients requiring anticoagulation, such as those undergoing cardiopulmonary bypass (CPB). Treatments to address heparin resistance include supplementation of antithrombin (AT)..

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Antithrombin Therapy: Current State and Future Outlook

Abstract Antithrombin (AT) is a natural anticoagulant pivotal in inactivating serine protease enzymes in the coagulation cascade, making it a potent inhibitor of blood clot formation. AT also possesses anti-inflammatory..

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The Rise and Fall of Antithrombin Supplementation in Cardiac Surgery

Abstract Various cohort studies, both retrospective and prospective, showed that low antithrombin levels after cardiac surgery (at the arrival in the intensive care unit and during the next days) were..

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Antithrombin Replacement and Extracorporeal Membrane Oxygenation: The time is ripe for a Simpler Solution

Abstract The use of extracorporeal membrane oxygenation (ECMO) circuit obligates the administration of systemic anticoagulation to avoid patient and circuit thrombosis. Identifying an optimal approach for achievement of target pharmacologic..

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The relationship between antithrombin administration and inflammation during veno-venous ECMO

Abstract Veno-venous Extracorporeal Membrane Oxygenation (ECMO) is used in the most severe cases of respiratory failure and further exacerbates the patients’ inflammatory status. Antithrombin is supplemented during ECMO for its..

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Activity of anticoagulant proteins on the polymer-coated and heparin-coated membranes in an extracorporeal circulation circuit

Abstract Introduction We performed in vitro experiments using whole human blood without anticoagulants to clarify the activity of anticoagulant proteins on membranes coated with acrylate-copolymer (ACP) with a hydrophilic blood-contacting layer compared..

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Antithrombin Dose Optimization in Extracorporeal Membrane Oxygenation in Infants

Abstract Anticoagulation in extracorporeal membrane oxygenation (ECMO) is challenging, with significant morbidity and mortality associated with thrombotic complications. Unfractionated heparin (UFH) is commonly used, which depends on native antithrombin (AT)..

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Anticoagulation and Transfusion Management During Neonatal and Pediatric Extracorporeal Membrane Oxygenation: A Survey of Medical Directors in the United States

Abstract OBJECTIVES:  To compare current practices within the United States of anticoagulation management and blood transfusion in neonatal and pediatric extracorporeal membrane oxygenation patients with a 2013 international report. DESIGN: ..

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A Pilot Study of Antithrombin Replacement Prior to Cardiopulmonary Bypass in Neonates

Abstract Neonates have low levels of antithrombin. Inadequate anticoagulation during cardiopulmonary bypass (CPB) due to low antithrombin activity may result in a poor preservation of the coagulation system during bypass...

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Challenges with heparin-based anticoagulation during cardiopulmonary bypass in children: Impact of low antithrombin activity

Abstract Background  is one of the main natural  inhibitors. It is potentiated by heparin, and may be a key component of heparin response, particularly in infants aged <1 year. We sought to..

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Successful Antithrombin Administration in Andexanet Alfa-Associated Heparin Resistance

Abstract Case Report A 72-year-old man with a tachycardiomyopathy, atrium flutter, and atrial fibrillation underwent an elective radiofrequency ablation procedure. In addition to 5 mg of apixaban twice daily, his..

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Double-Blind, Randomized, Placebo-Controlled Trial Comparing the Effects of Antithrombin Versus Placebo on the Coagulation System in Infants with Low Antithrombin…

Abstract Objectives To determine whether precardiopulmonary bypass (CPB) normalization of  levels in infants to 100% improves heparin sensitivity and  during CPB and has beneficial effects into the . Design Randomized, double-blinded, placebo-controlled prospective..

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Anticoagulation Management and Antithrombin Supplementation Practice during Veno-venous Extracorporeal Membrane Oxygenation: A Worldwide Survey

Background There is a lack of consensus on how to manage anticoagulation during veno-venous extracorporeal membrane oxygenation, including antithrombin monitoring and supplementation. The authors’ aim was to determine current practice..

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