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Anti-Xa Directed Thromboprophylaxis in Critically Ill Patients with Coronavirus Disease 2019.
Mohamed, Adham; Shemanski, Shelby M; Saad, Mohamed O; Ploetz, Jeannette; Haines, Michelle M; Schlachter, Andrew B; Hamarshi, Majdi S.
  • Mohamed A; 24091Saint Luke's Hospital of Kansas City, Kansas City, MO, USA.
  • Shemanski SM; 24091Saint Luke's Hospital of Kansas City, Kansas City, MO, USA.
  • Saad MO; Al-Wakra Hospital, 36977Hamad Medical Corporation, Doha, Qatar.
  • Ploetz J; 24091Saint Luke's Hospital of Kansas City, Kansas City, MO, USA.
  • Haines MM; 24091Saint Luke's Hospital of Kansas City, Kansas City, MO, USA.
  • Schlachter AB; 12272University of Missouri-Kansas City, School of Medicine, Kansas City, MO, USA.
  • Hamarshi MS; 24091Saint Luke's Hospital of Kansas City, Kansas City, MO, USA.
Clin Appl Thromb Hemost ; 28: 10760296221116350, 2022.
Статья в английский | MEDLINE | ID: covidwho-1974064
ABSTRACT

Objective:

To compare Anti-Xa directed thromboprophylaxis using low molecular weight heparin (LMWH) (anti-Xa peak goal 0.2-0.5 IU/mL) to alternative anticoagulation strategies in critically ill COVID-19 patients.

Methods:

This was a retrospective, multicenter, single health-system study. Primary outcomes were thromboembolic events and clinically important bleeding events. Secondary outcomes included dosing comparisons between LMWH cohorts. Main

Results:

A total of 695 patients were included. No differences were found in the incidence of thrombotic events with any of the dosing strategies. The incidence of major bleeding was significantly higher in the standard dose thromboprophylaxis, intermediate dose subcutaneous heparin (SQH), and therapeutic anticoagulation cohorts. Forty-nine percent of patients within the anti-Xa directed group had their first anti-Xa peak at goal, while 43% were above goal. Patients who had levels above goal had dose modifications made, therefore anti-Xa directed LMWH resulted in significantly lower total daily doses compared to intermediate dose LMWH.

Conclusions:

Anti-Xa directed LMWH dosing provided comparable thromboprophylaxis with lower total daily doses of LMWH in critically ill COVID-19 patients. Further randomized controlled trials are needed to confirm our findings.
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Полный текст: Имеется в наличии Коллекция: Международные базы данных база данных: MEDLINE Основная тема: Venous Thromboembolism / COVID-19 Тип исследования: Когортное исследование / Экспериментальные исследования / Наблюдательное исследование / Прогностическое исследование / Рандомизированные контролируемые испытания Пределы темы: Люди Язык: английский Журнал: Clin Appl Thromb Hemost Тематика журнала: Болезни системы кровообращения Год: 2022 Тип: Статья Аффилированная страна: 10760296221116350

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Полный текст: Имеется в наличии Коллекция: Международные базы данных база данных: MEDLINE Основная тема: Venous Thromboembolism / COVID-19 Тип исследования: Когортное исследование / Экспериментальные исследования / Наблюдательное исследование / Прогностическое исследование / Рандомизированные контролируемые испытания Пределы темы: Люди Язык: английский Журнал: Clin Appl Thromb Hemost Тематика журнала: Болезни системы кровообращения Год: 2022 Тип: Статья Аффилированная страна: 10760296221116350