| Autor: |
Van Lancker, Ruth, Simke, Demeester, Jochmans, Kristin, Mekeirele, Michaël Maurits M |
| Přispěvatelé: |
Intensive Care, Pharmaceutical and Pharmacological Sciences, Hematology, Clinical sciences, Clinical Biology, Diabetes Pathology & Therapy, Reproductive immunology and implantation |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
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| Popis: |
Background : During the first wave of COVID- 19 infections, a significantly higher incidence of thrombo- embolic events (TE) was reported. This led to some international guidelines favouring the administration of a higher dose of low molecular weight heparin (LMWH) as a prophylactic anticoagulation strategy. Despite switching to a dose of 100 IU/kg tinzaparin in COVID- 19 infected patients in our intensive care unit (ICU), we still experienced several ischemic events. Aims : To establish if anti- Xa plasma levels can determine the development of TE in COVID- 19 infected ICU patients. Methods : After obtaining ethical approval, we retrospectively collected data on anti- Xa levels from all COVID- 19 infected ICU patients, treated once daily with tinzaparin, on 2 random dates in November 2020 in UZ Brussel. Samples were obtained 4 h after injection, as required to measure reliable peak levels. We investigated whether these patients developed a TE within 14 days following sample collection. Results : We analysed 32 anti- Xa plasma levels from 24 patients, 19 from patients receiving a high prophylactic dose of tinzaparin (median dose = 103 IU/kg) and 13 from patients receiving a therapeutic dose (median dose = 177 IU/kg). None of the patients in the therapeutic group developed a TE within 14 days, in contrast with 6 patients in the high prophylactic group (Figure 1). All patients with anti- Xa levels below 0.23 IU/mL ( n = 4) developed a TE, as opposed to only 2 out of 15 with higher levels. However, due to a wide range in anti- Xa levels and a small sample size, there was no statistically significant difference in anti- Xa levels in patients with and without TE ( P - value = 0.123). |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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