[Fundamental studies on the management of disseminated intravascular coagulation (DIC) with antithrombin III (AT-III) concentrate].

The anticoagulant effect of antithrombin III (AT-III) in the management of disseminated intravascular coagulation (DIC) was investigated. When AT-III concentrate (4 mg/0.2 ml) was added to pregnant whole blood (0.8 ml), r(21.0 +/- 0.6 mm) and K(7.2 +/- 0.3 mm) (Mean +/- SE) were prolonged as compared with the saline control (C) (r: 18.6 +/- 0.6, K: 4.6 +/- 0.2 mm), and ma was decreased from 68.8 +/- 1.2 mm (C) to 60.3 +/- 1.0 mm (AT-III) on the TEG (p less than 0.01). PT and aPTT were also prolonged by the addition of AT-III concentrate (p less than 0.01). DIC models in rabbits were induced by continuous infusion of endotoxin (E). AT-III concentrate was administered two hours after starting infusion of E. Anticoagulant activity was evident on the TEG. In the data on coagulative and fibrinolytic factors, there were no significant differences between the control and the group administered AT-III concentrate. Fibrin deposits in the renal glomeruli were reduced after administration of AT-III concentrate (control: 46.5 +/- 38.7%, AT-III: 13.4 +/- 27.9%). The decreasing rate of AT-III antigen was the same in E infusion and non-infusion groups. However, the rate of decrease in activity was higher in the former than in the latter (rate of decrease: 40.0% and 24.6% 8 hours after administration of the AT-III concentrate). This indicated that inactive AT-III combined with thrombin and Xa might remain in the blood in DIC.