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Thromboprophylaxis in Critically Ill Coronavirus Disease 2019 Patients

It is now reported that coronavirus disease 2019 ICU patients are at increased risk of thrombosis. Expert opinion and scientific societies recommend a higher dose of low-molecular-weight heparin, but definitive data is lacking. We report our adapted thromboprophylaxis practice of low-molecular-weigh...

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Autores principales: Piagnerelli, Michaël, Cauchie, Philippe, Vancutsem, Maxime, Thooft, Aurélie, Zouaoui Boudjeltia, Karim, Biston, Patrick, Wautrecht, Jean-Claude
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392617/
https://www.ncbi.nlm.nih.gov/pubmed/32766568
http://dx.doi.org/10.1097/CCE.0000000000000177
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author Piagnerelli, Michaël
Cauchie, Philippe
Vancutsem, Maxime
Thooft, Aurélie
Zouaoui Boudjeltia, Karim
Biston, Patrick
Wautrecht, Jean-Claude
author_facet Piagnerelli, Michaël
Cauchie, Philippe
Vancutsem, Maxime
Thooft, Aurélie
Zouaoui Boudjeltia, Karim
Biston, Patrick
Wautrecht, Jean-Claude
author_sort Piagnerelli, Michaël
collection PubMed
description It is now reported that coronavirus disease 2019 ICU patients are at increased risk of thrombosis. Expert opinion and scientific societies recommend a higher dose of low-molecular-weight heparin, but definitive data is lacking. We report our adapted thromboprophylaxis practice of low-molecular-weight heparin administration in coronavirus disease 2019 ICU patients. One-hundred six measurements in 19 ICU patients were collected. Despite enoxaparin 60 mg once daily, only two measurements of the trough anti-Xa were in the upper end of prophylactic range. Anti-Xa activity peaks increased significantly after administration, but all measurements were under the optimal prophylactic ranges. Despite an adapted protocol, three of the 19 patients (16%) developed venous thromboembolism. We show in coronavirus disease 2019 ICU patients, despite higher prophylactic low-molecular-weight heparin administration due to body mass index, anti-Xa activity was well below peak serum levels in our cohort of critically ill coronavirus disease 2019 patients. This evaluation suggests the need for rapid studies on adequate thromboprophylaxis in these patients.
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spelling pubmed-73926172020-08-05 Thromboprophylaxis in Critically Ill Coronavirus Disease 2019 Patients Piagnerelli, Michaël Cauchie, Philippe Vancutsem, Maxime Thooft, Aurélie Zouaoui Boudjeltia, Karim Biston, Patrick Wautrecht, Jean-Claude Crit Care Explor Letter to the Editor It is now reported that coronavirus disease 2019 ICU patients are at increased risk of thrombosis. Expert opinion and scientific societies recommend a higher dose of low-molecular-weight heparin, but definitive data is lacking. We report our adapted thromboprophylaxis practice of low-molecular-weight heparin administration in coronavirus disease 2019 ICU patients. One-hundred six measurements in 19 ICU patients were collected. Despite enoxaparin 60 mg once daily, only two measurements of the trough anti-Xa were in the upper end of prophylactic range. Anti-Xa activity peaks increased significantly after administration, but all measurements were under the optimal prophylactic ranges. Despite an adapted protocol, three of the 19 patients (16%) developed venous thromboembolism. We show in coronavirus disease 2019 ICU patients, despite higher prophylactic low-molecular-weight heparin administration due to body mass index, anti-Xa activity was well below peak serum levels in our cohort of critically ill coronavirus disease 2019 patients. This evaluation suggests the need for rapid studies on adequate thromboprophylaxis in these patients. Lippincott Williams & Wilkins 2020-07-29 /pmc/articles/PMC7392617/ /pubmed/32766568 http://dx.doi.org/10.1097/CCE.0000000000000177 Text en Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Letter to the Editor
Piagnerelli, Michaël
Cauchie, Philippe
Vancutsem, Maxime
Thooft, Aurélie
Zouaoui Boudjeltia, Karim
Biston, Patrick
Wautrecht, Jean-Claude
Thromboprophylaxis in Critically Ill Coronavirus Disease 2019 Patients
title Thromboprophylaxis in Critically Ill Coronavirus Disease 2019 Patients
title_full Thromboprophylaxis in Critically Ill Coronavirus Disease 2019 Patients
title_fullStr Thromboprophylaxis in Critically Ill Coronavirus Disease 2019 Patients
title_full_unstemmed Thromboprophylaxis in Critically Ill Coronavirus Disease 2019 Patients
title_short Thromboprophylaxis in Critically Ill Coronavirus Disease 2019 Patients
title_sort thromboprophylaxis in critically ill coronavirus disease 2019 patients
topic Letter to the Editor
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392617/
https://www.ncbi.nlm.nih.gov/pubmed/32766568
http://dx.doi.org/10.1097/CCE.0000000000000177
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