Antifactor Xa activity in intensive care patients receiving thromboembolic prophylaxis with standard doses of enoxaparin

被引:89
作者
Mayr, AJ
Dünser, M
Jochberger, S
Fries, D
Klingler, A
Joannidis, M
Hasibeder, W
Schobersberger, W
机构
[1] Univ Innsbruck, Div Gen & Surg Intens Care Med, Dept Anaesthesia & Crit Care Med, A-6020 Innsbruck, Austria
[2] Univ Innsbruck, Div Theoret Surg, Dept Gen Surg, A-6020 Innsbruck, Austria
[3] Univ Innsbruck, Dept Internal Med, A-6020 Innsbruck, Austria
关键词
enoxaparin; intensive care; antifactor Xa; MODS; body weight;
D O I
10.1016/S0049-3848(02)00028-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Low-molecular-weight heparins (LMWHs) have become increasingly used to prevent thromboembolic complications in intensive care patients. Unlike in medical and surgical patients, no data on the anticoagulant effectiveness of standard LMWH dosages exist in intensive care patients. Therefore, we prospectively investigated antifactor Xa (aFXa) levels after subcutaneous administration of 40 mg of enoxaparin in 89 intensive care patients over a 24-h period. Methods: AFXa levels were measured before, 4, 12 and 24 h after subcutaneous administration of enoxaparin. Laboratory parameters including prothrombin time, activated partial thromboplastin time, antithrombin III, fibrinogen as well as platelet count were collected at same intervals. Demographics included age, sex, height, weight, body mass index, admission diagnosis, a thromboembolic risk score and a modified Goris multiple or.-an dysfunction score. Results: At 4, 12 and 24 h, 56.5%, 39.3% and 12.6% of the study patients were within recommended antithrombotic aFXa levels (0.1 -0.3 U ml(-1)). Presence of multiple organ dysfunction as well as high body weight were significantly correlated with low aFXa levels. Conclusion: European standard dosages of 40 mg of enoxaparin once daily proved to be ineffective in achieving recommended antithrombotic aFXa levels in intensive care patients. This was most pronounced in patients with high body weight and presence of multiple organ dysfunction. (C) 2002 Elsevier Science Ltd. All rights reserved.
引用
收藏
页码:201 / 204
页数:4
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