Scientific rationale for the use of antithrombin III in a multidisciplinary clinic

Rationale. Antithrombin III (AT) is one of the most important natural inhibitors of blood coagulation. Antithrombin deficiency is usually detected when a patient has recurrent venous thrombosis and pulmonary embolism. Antithrombin activity is significantly enhanced in the presence of heparin, and the anticoagulant effect of heparin depends on the presence of antithrombin. Objective: to identify patterns of AT infusions in a multidisciplinary hospital, to assess the compliance of AT use with medical care standards. Methods. Retrospectively, based on the materials of 44,221 electronic medical records, the determination of plasma levels and the administration of AT to patients of the Pirogov Center hospital in 2024 were studied. The data were analyzed using descriptive statistics at a significance level of 0.05. Results. Of the 44,221 patients of the hospital, the AT concentration was determined in 48 people (in 1 – twice) (0.1%): 26 women and 22 men aged 51.8 ± 14.2 (hereinafter: mean ± standard deviation) years, from 23 to 85 years. AT level – 98.1 ± 21.1% (from 43 to 125%). Fatal outcome – 1 (in a patient with an AT level of 43%). 37 antithrombin activity results were within normal limits. 8 – unavailable, usually due to testing on the eve of hospital discharge. 5 results – below normal. In 2024, AT was administered to 2 patients. Patient V., 34 years old. Pancreatic necrosis, sepsis. Treatment period is 54 days. On the 3rd day of hospitalization, the AT level was 61%. 4 vials of the drug were administered (1 vial per day). The AT level increased to 80%. 50 doses of red blood cells and 3 doses of plasma were transfused. Patient M., 79 years old. Ischemic stroke, sepsis. Treatment period is 22 days. 1 vial of the drug was administered. No blood was transfused. Both patients were discharged with improvement. 10 patients (21%) received blood transfusion therapy: Conclusion. Both the determination of activity and the order of antithrombin infusion: – are absent from the standards of medical care, – are prescribed by individual doctors to search for the causes of possible thrombophilia and antithrombotic therapy, respectively. The level of antithrombin in the group of blood recipients was 81.6±19.9%, which is significantly lower than in the group of non-recipients of blood was 105.8±5.7% (t-criterion 3.501, p = 0.001).