Purpose — to assess the efficacy of supplementation therapy for antithrombin deficiency in the combined treatment of sepsis.Materials and methods. A prospective-retrospective study of the efficacy of supplementation therapy for antithrombin deficiency during sepsis was carried out; 90 patients were examined. The patients were split into two groups whether antithrombin deficiency correction was or was not undertaken. The composite outcome — the incidence of cardiovascular complications as of day 28 from the therapy commencement — was chosen as the primary endpoint of the study. The secondary endpoints of the study were prevalence of adverse events as of day 28 from the therapy commencement and 180-day mortality.Results. There was no difference between the groups either in respect of 28-day mortality or composite outcome. Analysis of secondary endpoints revealed that in the group of patients who received antithrombin supplementation therapy, the risk of development of an acute renal injury was significantly lower on day 28 and 180 from therapy commencement: OR 3.5 [95% CI 1.05–11.66] at P=0.04 and OR 2.92 [95% CI 1.02–8.31] at P=0.045, respectively.Conclusion. Correction of antithrombin level to activity level ‘over 61%’ is associated with decreased incidence degree III acute kidney failure (KDIGO).

RUSSIAN JOURNAL OF ANAESTHESIOLOGY AND REANIMATOLOGY 3, 2018 Сепсис — патологический процесс, основу которого составляют генерализованная реакция воспаления (Systemic Inflammatory Response Syndrome — SIRS) и противовоспалительный синдром (Compensatory anti-inflammatory response syndrome — CARS). Определение сепсиса принято в 1992 г. Чикагской международной согласительной конференцией Американской ассоциации торакальных врачей ( American College of Chest Physicians — АССР) и общеРоль антитромбина в диагностике и лечении сепсиса

Antithrombin is one of the key regulating factors of homeostasis, which activity significantly reduces in SIRS. The objective of the study : to investigate possibility and feasibility to test antithrombin level in blood plasma in order to predict treatment outcomes in patients with sepsis. Subjects. The level of antithrombin was tested in 83 patients by the start and at the peak of the disease. Predictive value was compared for antithrombin tests, some other parameters of coagulogram, and clinical severity scales in sepsis. Results. On the 5th day of the disease, the most significant predictors of the unfavorable outcome of sepsis were identified: fibrinogen level (Odds ratio – 2.42 [0.92–6.33]; p = 0.0722); and antithrombin level (Odds ratio – 26.4 [8.02 86.86]; p < 0.0001). Pair-wise comparison of ROC-curves of fibrinogen and antithrombin at the final point of the study demonstrated differences between areas under curve (AUC), which made 0.337 [95% CI 0.154–0.520] with p = 0.0003, which confirmed the assumption of the high predictive value of antithrombin level. With the cut-off point at ≤ 61% this test demonstrated the sensitivity and specificity of 79% and 88% respectively. Conclusion: In order to predict severity and potential outcome of sepsis, it is recommended to test antithrombin level at the peak of the disease.

Antithrombin is one of the key regulating factors of homeostasis, which activity significantly reduces in SIRS. The objective of the study : to investigate possibility and feasibility to test antithrombin level in blood plasma in order to predict treatment outcomes in patients with sepsis. Subjects. The level of antithrombin was tested in 83 patients by the start and at the peak of the disease. Predictive value was compared for antithrombin tests, some other parameters of coagulogram, and clinical severity scales in sepsis. Results. On the 5th day of the disease, the most significant predictors of the unfavorable outcome of sepsis were identified: fibrinogen level (Odds ratio – 2.42 [0.92–6.33]; p = 0.0722); and antithrombin level (Odds ratio – 26.4 [8.02 86.86]; p < 0.0001). Pair-wise comparison of ROC-curves of fibrinogen and antithrombin at the final point of the study demonstrated differences between areas under curve (AUC), which made 0.337 [95% CI 0.154–0.520] with p = 0.0003, which confirmed the assumption of the high predictive value of antithrombin level. With the cut-off point at ≤ 61% this test demonstrated the sensitivity and specificity of 79% and 88% respectively. Conclusion: In order to predict severity and potential outcome of sepsis, it is recommended to test antithrombin level at the peak of the disease.

A device for the fastening of a standard perfusion nozzle on flasks with thread-free necks for hemosorption is described. The device enables to perform hemosorption procedures when it is not appropriate to use standard 400-ml flasks.