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Eur J Cardiothorac Surg 2006;29:406-409
© 2006 Elsevier Science NL

Antithrombin activity in children with chylothorax

Vera Bernet-Buettiker a , * , Katharina Waldvogel a , Vincenzo Cannizzaro a , Manuela Albisetti b

a Division of Neonatology and Intensive Care, University Children's Hospital, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland
b Division of Hematology, University Children's Hospital, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland

Received 9 November 2005; received in revised form 8 December 2005; accepted 12 December 2005.

* Corresponding author. Tel.: +41 44 266 71 11; fax: +41 44 266 71 71. (Email: vera.bernet{at}kispi.unizh.ch).

Objective: To determine whether increased antithrombin loss is present in children with chylothorax after cardiac surgery. Methods: Plasma and pleural effusion samples of children with chylous and non-chylous pleural effusion were assayed for antithrombin activity. Results: Ten children with chylothorax and five children with non-chylous pleural effusion were investigated. There was statistically significant increase in mean antithrombin activity in chylous samples (32.2 ± 11.4%) compared to non-chylous samples (14.4 ± 13.9%), and significant decrease in plasma of children with chylothorax (44.6 ± 15.4%) compared to children with non-chylous pleural effusion (69.9 ± 22.4%). Seven of 10 children with chylous and none of the children without chylous developed thrombosis (p < 0.007). Conclusions: Increased loss of antithrombin is present in children with chylothorax, potentially predisposing these children to an increased risk of thrombosis. Repeated antithrombin substitution should be considered in critically ill children with chylothorax.

Key Words: Chylothorax • Antithrombin • Thrombosis • Children • Neonate






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Copyright © 2006 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.