Error in body weight estimation leads to inadequate parenteral anticoagulation
| Autor: | Leon Gustavo dos Reis Macedo, Antonio Pazin-Filho, Luciana R. de Oliveira, Maria Carolina Pintao, Andrea A. Garcia |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Resuscitation Adolescent Injections Subcutaneous Statistics Nonparametric Intensive care medicine Humans Prospective Studies Enoxaparin Prospective cohort study Aged Aged 80 and over Chi-Square Distribution business.industry Body Weight Anticoagulants Thrombosis General Medicine Heparin Emergency department Heparin Low-Molecular-Weight Middle Aged medicine.disease Surgery Basal (medicine) Anesthesia Emergency Medicine Female PESOS E MEDIDAS CORPORAIS Emergency Service Hospital business Chi-squared distribution medicine.drug |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP |
| ISSN: | 0735-6757 |
| DOI: | 10.1016/j.ajem.2010.01.006 |
| Popis: | Parenteral anticoagulation is a cornerstone in the management of venous and arterial thrombosis. Unfractionated heparin has a wide dose/response relationship, requiring frequent and troublesome laboratorial follow-up. Because of all these factors, low-molecular-weight heparin use has been increasing. Inadequate dosage has been pointed out as a potential problem because the use of subjectively estimated weight instead of real measured weight is common practice in the emergency department (ED). To evaluate the impact of inadequate weight estimation on enoxaparin dosage, we investigated the adequacy of anticoagulation of patients in a tertiary ED where subjective weight estimation is common practice. We obtained the estimated, informed, and measured weight of 28 patients in need of parenteral anticoagulation. Basal and steady-state (after the second subcutaneous shot of enoxaparin) anti-Xa activity was obtained as a measure of adequate anticoagulation. The patients were divided into 2 groups according the anticoagulation adequacy. From the 28 patients enrolled, 75% (group 1, n = 21) received at least 0.9 mg/kg per dose BID and 25% (group 2, n = 7) received less than 0.9 mg/kg per dose BID of enoxaparin. Only 4 (14.3%) of all patients had anti-Xa activity less than the inferior limit of the therapeutic range ( |
| Databáze: | OpenAIRE |
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