Antithrombin for severe burns: a systematic review and meta-analysis

Background : Anticoagulation therapies may reduce the rate of mortality associated with severe burns. However, only a few high-quality randomized controlled trials have been conducted in this regard, and clinical recommendations are lacking. In this study, we aimed to evaluate the effectiveness and safety of antithrombin-based interventions for severe burns. Main body of the abstract : We systematically reviewed and examined randomized controlled trials and observational studies on antithrombin administration for severe burns. Control groups were administered standard therapy or a placebo. The primary outcome was in-hospital mortality. We assessed the studies using the Cochrane risk-of-bias tool and the Grading of Recommendations Assessment, Development, and Evaluation approach. Two randomized controlled trials and one observational study were included. In the randomized controlled trials, antithrombin administration did not affect overall mortality (low certainty of evidence). However, antithrombin administration resulted in a significant reduction in 28-day mortality rate among patients with overt disseminated intravascular coagulation in one of these trials (high certainty of evidence). In the observational study, antithrombin administration resulted in a significant reduction in 28-day mortality rate (moderate certainty of evidence). Conclusions : Although antithrombin does not affect overall mortality, it may be effective in patients with overt disseminated intravascular coagulation. Given the limited number of available studies, further research and accumulation of high-quality evidence are warranted.