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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Enoxaparin, effective dosage for intensive care patients: double-blinded, randomised clinical trial. | Robinson et al. Critical Care 2010 14 R41 http ccforum.eom content 14 2 R41 c CRITICAL CARE RESEARCH Open Access Enoxaparin effective dosage for intensive care patients double-blinded randomised clinical trial 1 1 1 2 21 Sian Robinson Aleksander Zincuk Thomas Strom Torben Bjerregaard Larsen Bjarne Rasmussen Palle Toft Abstract Introduction Intensive care unit ICU patients are predisposed to thromboembolism. Routine prophylactic anticoagulation is widely recommended. Low-molecular-weight heparins such as enoxaparin are increasingly used because of predictable pharmacokinetics. This study aims to determine the subcutaneous SC dose of enoxaparin that would give the best anti-factor Xa levels in ICU patients. Methods The 72 patients admitted to a mixed ICU at Odense University Hospital OUH in Denmark were randomised into four groups to receive 40 50 60 or 70 mg SC enoxaparin for a period of 24 hours. Anti-factor Xa activity aFXa was measured before and at 4 12 and 24 hours after administration. An AFXa level between 0.1 to 0.3 IU ml was considered evidence of effective antithrombotic activity. Results Median peak 4 hours after administration aFXa levels increased significantly with an increase in enoxaparin dose from 0.13 IU ml at 40 mg to 0.14 IU ml at 50 mg 0.27 IU ml at 60 mg and 0.29 IU ml at 70 mg P 0.002 . At 12 hours after administration median aFXa levels were still within therapeutic range for those patients who received 60 mg P 0.02 . Conclusions Our study confirmed that a standard dose of 40 mg enoxaparin yielded subtherapeutic levels of aFXa in critically ill patients. Higher doses resulted in better peak aFXa levels with a ceiling effect observed at 60 mg. The present study seems to suggest inadequate dosage as one of the possible mechanisms for the higher failure rate of enoxaparin in ICU patients. Trial Registration ISRCTN03037804 Introduction Geerts et al. 1 determined the prevalence of deep vein thrombosis DVT in intensive care unit ICU patients not .
