The Use of Human Antithrombin III Concentrate for Treatment of Heparin Resistance During Cardiopulmonary Bypass

Abstract

We report the administration of biologic antithrombin III (AT III) concentrate for the treatment of heparin resistance in 44 patients undergoing cardiopulmonary bypass (CPB). During CPB, the amount of heparin required to maintain an activated clotting time greater than 480 sec was significantly reduced following the administration of AT III concentrate (p = .000). The average increase in the ACT was 176 sec following the administration of AT III concentrate (p = .000). Thirteen of 44 patients did not require any additional heparin for the duration of CPB after AT III therapy. AT III concentrate seemed to be efficacious in the treatment of heparin resistance attributable to presumed AT III deficiency. Moreover, the reduction in heparin requirements following administration of AT III concentrate may reduce postoperative bleeding associated with heparin rebound, protamine requirements, and its associated complications and threat of intravascular coagulation during CPB.