[Substitution of antithrombin III in shock patients]

In 15 patients admitted to the operative intensive care unit of the Institute of Anesthesiology for shock and with signs of DIC, antithrombin III (AT III) was substituted together with a continuous infusion of heparin. 1,000 units AT III were given after the first blood sampling. This was followed by 500 units after 24 h and after 48 h. 14 out of the 15 cases could be evaluated. The activity of AT III prior to substitution was below 75% in 10 cases and above 75% in 4 cases. The mean increase after substitution was 16%. The recovery was below 50% in cases with acute DIC whilst it was 90% in cases in a comparatively steady state. One unit AT III per kg body weight increased the activity of AT III in circulation by an average of 1% in acute DIC whilst the increase was 2% in cases without signs of acute DIC. The average half disappearance of the increase of AT III in circulation was 4.25 h in acute DIC but was 19.0 h when acute DIC was not detectable.