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Burn injuries cause dynamic alterations of the coagulative and fibrinolytic activities of the blood. Up to the present, there has been little research on the anti-coagulative therapies for burned patients. Herein we discuss the clinical significance of heparin therapy as viewed from the results of animal experiments and clinical experiences.For our animal experiments we induced deep burns covering 40% of the total body surface of rabbits by soaking their backs in 80°C water for 20 seconds, and we followed the hematological alterations. Examinations of the rabbits without therapy revealed that the platelet counts, fibrinogen, and the plasminogen decreased gradually after injury, and the FDP increased soon after injury. Examinations of the rabbits administred only the infusion therapy revealed that almost the same alterations took place as in the rabbits without therapy. On the other hand, in the rabbits administered 1, 000U/kg/6hr. heparin in addition to the infusion therapy, there were significant alterations: no decrease in the platlet count at all; a slight decrease of fibrinogen; and no increase in FDP.Our clinical administration of heparin in doses of 10, 000-20, 000U/day prevented DIG and was proved to be safe. In the severely burned patients, however, the therapeutic effect of heparin was underestimated because of the decrease in antithrombin III concentration; therefore, we recommended that concentrated antithrombin III and heparin be administered syncronously in severly burned patients.
- 一般社団法人 日本血栓止血学会の論文
一般社団法人 日本血栓止血学会 | 論文
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