Heparin monitoring: clinical outcome and practical approach
| Autor: | Noémie Despas, Hugues Jacqmin, Marc Chatelain, Jonathan Douxfils, Anne-Sophie Larock, Bernard Chatelain, François Mullier |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Danaparoid Fondaparinux Argatroban Pregnancy Thromboembolism Heparin-induced thrombocytopenia medicine Humans Intensive care medicine Heparin business.industry Anticoagulant Anticoagulants General Medicine Heparin Low-Molecular-Weight medicine.disease Treatment Outcome Female Anticoagulant Agent Drug Monitoring business medicine.drug |
| Zdroj: | Annales de biologie clinique. 74:637-652 |
| ISSN: | 0003-3898 |
| Popis: | Traditional anticoagulant agents such as unfractionated heparin (UFH), low molecular weight heparins (LMWHs), fondaparinux, danaparoid and bivalirudine are used in the prevention and treatment of thromboembolic diseases. However, these agents have limitations: their constraining parenteral route of administration and the need for regular coagulation monitoring for HNF. The LMWHs, with their more predictable anticoagulant response, don't require a systematic monitoring. The usefulness of LMWHs monitoring in several clinical situations such as pregnancy, obesity and renal insufficiency is a matter of debate. Indeed, there is no agreement between French and American recommendations on this question. Others aspects are also controversial: the measure of trough anti-Xa activity during pregnancy and the optimal monitoring of LMWHs for patients with antithrombin deficiency (hepatic disease, new-borns). Different tests are available to ensure the monitoring of these drugs, we will see in this review their principle, their advantages and inconvenients. The management of heparin induced thrombocytopenia also needs parenteral anticoagulants: danaparoïd, bivalirudine or argatroban. The modalities of their monitoring are relatively unknown and are presented. Furthermore, platelet monitoring is capital. This article aims to provide guidance about laboratory testing of classic parenteral anticoagulants. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|