Evaluation of the Relevance of Antithrombin Prescriptions at Strasbourg University Hospitals

Antithrombin (AT) is a physiological inhibitor of the coagulation cascade. In therapeutics, its presence in sufficient quantities is necessary for the pharmacological activity of unfractionated heparin (UFH) and partially low-molecular-weight heparin (LMWH).

In intensive care, patients are mostly treated with anticoagulants for either preventive or curative purposes, particularly for those whose care requires renal replacement therapy (RRT), extracorporeal membrane oxygenation (ECMO), or cardiopulmonary bypass (CPB). The use of various types of membranes associated with these procedures can lead to degradation of blood proteins (including AT). An imbalance in hemostasis can then occur, resulting in ineffective anticoagulation. At the Strasbourg University Hospitals (HUS), these medications are directly available in the intensive care units, allowing for immediate administration in an emergency. Pharmaceutical and medical analysis is therefore not performed before administration.