Measuring the anticoagulant effect of low molecular weight heparins in the critically ill.

Abstract:

:Antithrombotic prophylaxis in critically ill patients frequently fails. Venous thromboembolism is associated with adverse clinical outcomes, including a prolonged intensive care unit stay and death. A potential mechanism by which critically ill patients may be predisposed to antithrombotic failure is the inability to achieve 'prophylactic' anticoagulant drug levels as a result of impaired absorption. For example, previous studies have shown that patients on inotropes have reduced serum levels of low molecular weight heparin, presumably on the basis of reduced absorption from the subcutaneous injection site. In the previous issue of the journal, Rommers and colleagues examined whether subcutaneous edema reduces absorption of a low molecular weight heparin; although small, and thus underpowered, the authors failed to find any relationship between the level of low molecular weight heparin and the presence of edema. These findings provide reassurance that subcutaneously administered medications may be used in critically ill patients with edema.

journal_name

Crit Care

authors

Crowther M,Lim W

doi

10.1186/cc4978

subject

Has Abstract

pub_date

2006-01-01 00:00:00

pages

150

issue

4

eissn

1364-8535

issn

1466-609X

pii

cc4978

journal_volume

10

pub_type

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