Key result
Increasing the dose of enoxaparin up to 70 mg in critically ill patients resulted in a dose-dependent increase in peak anti-factor Xa levels to 0.29 IU/ml, compared to 0.13 IU/ml with the conventional 40 mg dose.
Why the study?
Does higher dose enoxaparin improve plasma anti-factor-Xa activity levels in critically ill patients admitted to the ICU?
Does higher dose enoxaparin improve plasma anti-factor-Xa activity levels in critically ill patients admitted to the ICU?
Critically ill patients may require higher than conventional doses of enoxaparin to achieve adequate anti-factor Xa levels for thromboprophylaxis.
Venous thromboembolism is a relatively frequently occurring complication in critically ill patients admitted to the ICU despite prophylactic treatment with subcutaneous low molecular weight heparin. Several studies show that critically ill patients have significantly lower plasma anti-factor-Xa activity levels compared to control patients after administration of subcutaneous heparin. Robinson and colleagues show in this issue of Critical Care dose-dependent but relatively low levels of anti-factor Xa activity at increasing doses of enoxaparin. Anti-factor Xa levels thought to be required for adequate thromboprophylaxis are observed only at doses of enoxaparin that are one and a half times higher than the conventional dose (40 mg).
No takes yet. Share an insight, caveat, or question.
Marcel Levi (2010) conducted an editorial in Critically ill patients requiring thromboprophylaxis. Enoxaparin vs. Conventional dose (40 mg) was evaluated on Peak anti-factor Xa levels (4 hours after injection). Increasing the dose of enoxaparin up to 70 mg in critically ill patients resulted in a dose-dependent increase in peak anti-factor Xa levels to 0.29 IU/ml, compared to 0.13 IU/ml with the conventional 40 mg dose.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: