Key result
Thromboelastography reveals persistent anticoagulation despite guideline-directed enoxaparin discontinuation in moderate renal impairment.
Why the study?
Does thromboelastography demonstrate persistent anticoagulation after stopping enoxaparin in a patient with moderate renal impairment?
Case Report (n=1)
Does thromboelastography demonstrate persistent anticoagulation after stopping enoxaparin in a patient with moderate renal impairment?
Thromboelastography is a useful tool to detect persistent anticoagulation after stopping enoxaparin in patients with renal impairment, suggesting current discontinuation guidelines may lack a sufficient safety margin.
Current enoxaparin discontinuation guidelines may not ensure adequate reversal in moderate renal impairment; leaves open whether thromboelastography should guide management.
Peri-operative guidelines exist for neuraxial anaesthesia and anticoagulant therapy. We describe the use of thromboelastography to assess the coagulation status of a patient with moderate renal impairment who had been receiving enoxaparin and was being managed in accordance with current recommendations. This report demonstrates that current guidelines for discontinuing treatment with enoxaparin may not allow a sufficient safety margin in all patient groups and that thromboelastography is a useful tool in such situations.
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Simons et al. (2007) conducted a case report in Moderate renal impairment receiving enoxaparin (n=1). Thromboelastography was evaluated on Coagulation status (persistent anticoagulation). Thromboelastography demonstrated persistent anticoagulation in a patient with moderate renal impairment despite discontinuing enoxaparin according to current guidelines.
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