Pre- and Postoperative Levels of Antithrombin III with Special Reference to Thromboembolism After Total Hip Replacement

H Fredin; B Nilsson; B Rosberg; L Tengborn

doi:10.1055/s-0038-1657352

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1983; 49(03): 158-161
DOI: 10.1055/s-0038-1657352

Original Article

Schattauer GmbH Stuttgart

Pre- and Postoperative Levels of Antithrombin III with Special Reference to Thromboembolism After Total Hip Replacement

Authors

H Fredin

¹The Department of Orthopaedic Surgery, Malmö General Hospital, University of Lund, Malmö, Sweden
B Nilsson

²The Department of Clinical Chemistry, Malmö General Hospital, University of Lund, Malmö, Sweden
B Rosberg

³The Department of Anaesthesiology, Malmö General Hospital, University of Lund, Malmö, Sweden
L Tengborn

⁴The Department of Coagulation Disorders, Malmö General Hospital, University of Lund, Malmö, Sweden

Abstract

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Summary

A prospective study of antithrombin HI, determined by electroimmunochemical assay or an amidolytical method, was carried out with special reference to thromboembolism after total hip replacement. Two hundred and seven patients were randomly allocated to thromboembolic prophylaxis with dextran 70 or low dose heparin combined with dihydroergotamine. Deep vein thrombosis determined by phlebography of the operated leg or pulmonary embolism diagnosed with perfusion/ventilation scintigraphy developed in 51% of the total material and did not differ significantly between the two groups of prophylaxis or between patients with a preoperative At III below normal and those with a normal value. The correlation between the two assay methods for At HI was 0.61. An initial, postoperative decrease in At III was noted with a parallel fall in hematocrit and fibrinogen, later followed by an increase of the plasma proteins. It is concluded that the immediate postoperative decrease of At III is mostly due to hemodilution.

Keywords

Antithrombin III - Dextran - Heparin + dihydroergotamine - Hip replacement - Postoperative thromboembolism - Thromboprophylaxis

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References

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