No effect of norepinephrine dose on anti-Xa activity in critically ill patients
| Autor: | Norbert A. Foudraine, Jos L M L le Noble, Sjoerd D. Meenks, Kelly Broen, Paddy K.C. Janssen |
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| Přispěvatelé: | RS: NUTRIM - R3 - Respiratory & Age-related Health, MUMC+: DA KFT Medische Staf (9), Farmacologie en Toxicologie |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Critical Illness venous thromboembolism Pilot Projects intensive care unit law.invention Norepinephrine (medication) Norepinephrine VTE prophylaxis chemistry.chemical_compound dalteparin law Humans Medicine Pharmacology (medical) Prospective Studies Risk factor vasopressor therapy molecular-weight heparins Pharmacology Creatinine business.industry Anticoagulants Intensive care unit LMWH Confidence interval Intensive Care Units chemistry Anesthesia Cohort business Body mass index Venous thromboembolism Factor Xa Inhibitors medicine.drug |
| Zdroj: | International Journal of Clinical Pharmacology and Therapeutics, 58(4), 223-229. Dustri-Verlag Dr. Karl Feistle |
| ISSN: | 0946-1965 |
| Popis: | Objective: Low-molecular-weight heparins are frequently used to prevent venous thromboembolism. Vasopressor therapy may be associated with inadequate anti-factor Xa activity, thereby increasing the risk of venous thromboembolism. We aimed to assess the association between anti-factor Xa activity and norepinephrine dose in intensive care unit (ICU) patients treated with subcutaneous dalteparin for venous thromboembolism prophylaxis. Materials and methods: This was a prospective observational pilot study in adult ICU patients treated with dalteparin 5,000 RJ subcutaneously once daily and norepinephrine > 0.25 mu g/kg/min. Peak anti-factor Xa activity was monitored and dalteparin doses were adjusted following a predefined dose algorithm. Results: From November 2016 to April 2018, 32 patients were included. No correlation was found between norepinephrine dose and anti-factor Xa activity (r = -0.01, 95% confidence interval = -0.47 - 0.27, p = 0.57). Furthermore, following daltcparin 5,000 RI once daily, 28% of the patients showed anti-factor Xa activity < 0.10 IU/mL. Higher body mass index (BM1) (p < 0.001) but not patients' norepinephrine dose, age, or serum creatinine were risk factors for anti-factor Xa activity < 0.10 IU/mL. Dose increments to 7,500 IU once daily resulted in anti-factor Xa activity >= 0.10 IU/mL in all 5 patients (p = 0.043). Conclusion: In this cohort of ICU patients, no association was found between norepinephrine dose and anti-factor Xa activity following subcutaneous dalteparin 5,000-RJ administration once daily. Furthermore, nearly one-third of the patients showed anti-factor Xa activity below the target concentration for venous thromboembolism prophylaxis. Higher BMI was an independent risk factor for reduced anti-Xa activity. |
| Databáze: | OpenAIRE |
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