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Intervention Review

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Antithrombin III for critically ill patients

  1. Arash Afshari1,*,
  2. Jørn Wetterslev2,
  3. Jesper Brok3,
  4. Ann Merete Møller4

Editorial Group: Cochrane Anaesthesia, Critical and Emergency Care Group

Published Online: 16 JUL 2008

Assessed as up-to-date: 4 NOV 2006

DOI: 10.1002/14651858.CD005370.pub2


How to Cite

Afshari A, Wetterslev J, Brok J, Møller AM. Antithrombin III for critically ill patients. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD005370. DOI: 10.1002/14651858.CD005370.pub2.

Author Information

  1. 1

    Rigshospitalet, The Cochrane Anaesthesia Review Group & Copenhagen Trial Unit and Department of Paediatric and Obstetric Anaesthesia, Copenhagen, Denmark

  2. 2

    Rigshospitalet, Copenhagen University Hospital, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Copenhagen, Denmark

  3. 3

    Rigshospitalet, Paediatric Department 4072, Copenhagen, Denmark

  4. 4

    Herlev University Hospital, The Cochrane Anaesthesia Review Group, Rigshospitalet & Department of Anaesthesiology, Herlev, Denmark

*Arash Afshari, The Cochrane Anaesthesia Review Group & Copenhagen Trial Unit and Department of Paediatric and Obstetric Anaesthesia, Rigshospitalet, Blegdamsvej 9, Afsnit 3342, rum 52, Copenhagen, 2100, Denmark. arriba.a@gmail.com. afshari@rocketmail.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 16 JUL 2008

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This is not the most recent version of the article. View current version (08 FEB 2016)

[Figure 1]
Figure 1. Funnel plot, overall mortality regardless of follow up (quality)
[Figure 2]
Figure 2. How searching results found
[Figure 3]
Figure 3. Trial sequential analysis of all trials of the effect of ATIII on mortality. Cumulative z-curve in blue does not cross the trial sequential monitoring boundary (full red line with open diamonds) constructed for a low bias heterogeneity adjusted information size of 14,294 patients corresponding to a RRR of 5% with an alfa=0.05 and a power of 80% (beta = 0.20). Only 24% of the required information size has been reached so far.
[Figure 4]
Figure 4. Trial sequential analysis (TSA) of all trials of the effect of ATIII on mortality. Cumulative z-curve in blue does not cross the boundary constructed for an information size of 3317 patients in the meta-analysis (full red line with open diamonds) with a RRR of 10% (alfa = 0.05) and a power of 80% (beta = 0.20). With the total number of accrued participants in randomized trials being 3458 we are able to reject a RRR of 10% with a power of 80%.
[Analysis 1.1]
Analysis 1.1. Comparison 1 AT III versus control, Outcome 1 Mortality (subgroup analysis on bias risk).
[Analysis 1.2]
Analysis 1.2. Comparison 1 AT III versus control, Outcome 2 Overall mortality (subgroup analysis on random sequence generation).
[Analysis 1.3]
Analysis 1.3. Comparison 1 AT III versus control, Outcome 3 Overall mortality (subgroup analysis on allocation concealment).
[Analysis 1.4]
Analysis 1.4. Comparison 1 AT III versus control, Outcome 4 Overall mortality (subgroup analysis on blinding).
[Analysis 1.5]
Analysis 1.5. Comparison 1 AT III versus control, Outcome 5 Overall mortality (subgroup analysis on completeness of follow up).
[Analysis 1.6]
Analysis 1.6. Comparison 1 AT III versus control, Outcome 6 Overall mortality (subgroup analysis on ITT).
[Analysis 1.7]
Analysis 1.7. Comparison 1 AT III versus control, Outcome 7 Overall mortality (subgroup analysis on median follow up).
[Analysis 1.8]
Analysis 1.8. Comparison 1 AT III versus control, Outcome 8 Overall mortality (subgroup analysis on duration of intervention).
[Analysis 1.9]
Analysis 1.9. Comparison 1 AT III versus control, Outcome 9 Overall mortality (trauma).
[Analysis 1.10]
Analysis 1.10. Comparison 1 AT III versus control, Outcome 10 Overall mortality (obstetrics).
[Analysis 1.11]
Analysis 1.11. Comparison 1 AT III versus control, Outcome 11 Overall mortality (paediatrics).
[Analysis 1.12]
Analysis 1.12. Comparison 1 AT III versus control, Outcome 12 Overall mortality (heparin; Warren 2001 as a trial with adjuvant heparin therapy).
[Analysis 1.13]
Analysis 1.13. Comparison 1 AT III versus control, Outcome 13 Overall mortality (heparin; Warren 2001 as a trial without adjuvant heparin therapy).
[Analysis 1.14]
Analysis 1.14. Comparison 1 AT III versus control, Outcome 14 Overall mortality (heparin; Warren 2001 data split based on Heparin administration).
[Analysis 1.15]
Analysis 1.15. Comparison 1 AT III versus control, Outcome 15 Complications during the in-patient stay specific to the trial intervention (intracranial bleeding).
[Analysis 1.16]
Analysis 1.16. Comparison 1 AT III versus control, Outcome 16 Complications during the in-patient stay not specific to the trial intervention (renal failure).
[Analysis 1.17]
Analysis 1.17. Comparison 1 AT III versus control, Outcome 17 Complications during the in-patient stay not specific to the trial intervention (pneumothorax).
[Analysis 1.18]
Analysis 1.18. Comparison 1 AT III versus control, Outcome 18 Complication specific to the trial intervention other than bleeding.
[Analysis 1.19]
Analysis 1.19. Comparison 1 AT III versus control, Outcome 19 Bleeding events.
[Analysis 1.20]
Analysis 1.20. Comparison 1 AT III versus control, Outcome 20 Amount of red blood cells administered.
[Analysis 1.21]
Analysis 1.21. Comparison 1 AT III versus control, Outcome 21 Subjective overall quality of life assessment.
[Analysis 1.22]
Analysis 1.22. Comparison 1 AT III versus control, Outcome 22 Objective assessment of physical performance and dependency (Karnofsky).
[Analysis 1.23]
Analysis 1.23. Comparison 1 AT III versus control, Outcome 23 Incidence of surgical intervention.
[Analysis 1.24]
Analysis 1.24. Comparison 1 AT III versus control, Outcome 24 Severity of sepsis I.
[Analysis 1.25]
Analysis 1.25. Comparison 1 AT III versus control, Outcome 25 Severity of sepsis II.
[Analysis 1.26]
Analysis 1.26. Comparison 1 AT III versus control, Outcome 26 Severity of sepsis III.
[Analysis 1.27]
Analysis 1.27. Comparison 1 AT III versus control, Outcome 27 Severity of Ilness score.
[Analysis 1.28]
Analysis 1.28. Comparison 1 AT III versus control, Outcome 28 Incidence of respiratory failure not present at admission.
[Analysis 1.29]
Analysis 1.29. Comparison 1 AT III versus control, Outcome 29 Duration of mechanical ventilation.
[Analysis 1.30]
Analysis 1.30. Comparison 1 AT III versus control, Outcome 30 Length of stay in hospital.
[Analysis 1.31]
Analysis 1.31. Comparison 1 AT III versus control, Outcome 31 Mean length of stay in ICU.
[Analysis 1.32]
Analysis 1.32. Comparison 1 AT III versus control, Outcome 32 Overall mortality among septic population.