Antithrombin and protein C in systemic inflammatory response syndrome

Area of Science:

• Cardiovascular Surgery
• Hematology
• Critical Care Medicine

Background:

• Coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB) can trigger a systemic inflammatory response syndrome (SIRS).
• Preoperative deficiencies in antithrombin and protein C may influence patient outcomes after CPB.
• Understanding the prevalence of these deficiencies is crucial for risk stratification.

Purpose of the Study:

• To determine the prevalence of preoperative antithrombin and protein C deficiencies in patients undergoing CABG with CPB.
• To assess the relationship between these deficiencies and the incidence of SIRS.

Main Methods:

• Prospective measurement of antithrombin and protein C levels in 130 patients undergoing CABG with CPB.
• Analysis of patient demographics, surgical variables (CPB time, temperature), and clinical outcomes (SIRS development).
• Logistic regression was used to identify predictive factors for SIRS.

Main Results:

• SIRS developed in 27.7% of patients, associated with male gender, lower EuroSCORE, longer CPB time, higher pre-bypass temperature, and shorter activated coagulation time.
• Antithrombin levels < 80% were found in 33.8% of patients; protein C levels < 80% were found in 11.6%.
• Bypass duration and pre-bypass temperature were predictive of SIRS, while low antithrombin was a negative predictive factor.

Conclusions:

• Preoperative antithrombin and protein C deficiencies are prevalent in adults undergoing cardiac surgery with CPB.
• Despite their prevalence, these deficiencies did not identify patients at increased risk for developing SIRS post-operatively.