Early Thrombomodulin Improved Disseminated Intravascular Coagulation After Cardiac Surgery.

Background: Disseminated intravascular coagulation (DIC) is a fatal complication in postoperative patients. Recombinant human thrombomodulin (rhTM) has been used to treat DIC in some settings; however, the use of rhTM as a therapy for DIC has not been established in the field of cardiovascular surgery. This study aimed to investigate the efficacy and optimal timing of rhTM treatment in patients with DIC after cardiovascular operation. Methods: Data were retrospectively collected from patients in whom DIC developed after open cardiac operation and who were treated with rhTM. DIC scores, laboratory data, and major complications were assessed. The end point was the 30-day all-cause mortality. Risk factors influencing mortality were extracted for the survival and nonsurvival groups. Results: A total of 27 patients with postoperative DIC were treated with rhTM. The 30-day mortality rate was 51.9%. Multivariate analysis revealed that rhTM administration ≥5 days after DIC diagnosis was associated with increased mortality. The early administration group (≤4 days after DIC diagnosis) showed significantly improved DIC scores, reduced C-reactive protein levels, and increased number of platelets after rhTM treatment compared with before treatment. Conclusions: Early administration of rhTM after DIC diagnosis was associated with a decreased 30-day mortality rate in patients after cardiovascular operation.