Thrombelastography versus AntiFactor Xa levels in the assessment of prophylactic-dose enoxaparin in critically ill patients.

摘要: Background: A standard dose of enoxaparin is frequently used for deep venous thrombosis (DVT) prophylaxis. Evidence suggests inconsistent bioavailability in intensive care unit (ICU) patients. Antifactor Xa activity (anti-Xa) has been to monitor dosing but its accuracy and availability are problematic. Thrombelastography (TEG) evaluate coagulation diverse settings. The purpose this study was analyze whether TEG could be predict which enoxaparin-treated patients would develop DVT. Methods: Two hundred sixty-one simultaneous enoxaparin-active (active) enoxaparin-neutralized (neutral) TEGs were performed 61 surgical ICU over four consecutive days. Patient characteristics anti-Xa collected. DVT screening per protocol. Results: Mean (±SEM) age 54 (±2.3) years Acute Physiology Chronic Health Evaluation II score 17 (±0.7). There 30 trauma 31 general surgery (69% men). rate 28%. Time clot formation (R) percent lysis at minutes different between active versus neutralized blood (p < 0.001). R time 1.5 shorter with those without 0.001) indicating hypercoagulability Anti-Xa levels similar (0.135 ± 0.012) 0.007) = 0.97). no differences age, body mass index, injury severity score, or status non-DVT groups. Conclusions: demonstrates enoxapatin-neutralized that may guide dosing. differentiates who subsequently while do not. an enoxaparin-related increase fibrinolysis.