Zeitschrift für Intensiv- und Intensivpflege Offener Zugang

Abstrakt

Evaluation of Unfractionated Heparin Dosing for Thromboprophylaxis using Anti-Xa Levels in Obese Critically Ill Patients: A Retrospective Study

Joaquin Cagliani, Kusuma Nio, Wenchen Wu, Candace J Smith, Ernesto P Molmenti, Jeffrey Nicastro, Gene F Coppa and Rafael Barrera

Purpose: This study aims to evaluate whether current dosing recommendations of UFH for the prevention of thromboembolism is appropriate in obese critically ill patients utilizing Anti-Xa levels.

Materials and methods: A pilot, observational and retrospective chart review of critically ill patients was evaluated. Patients aged ≥ 18 years were included if they received subcutaneous UFH for thromboprophylaxis and had a recorded Anti-Xa level taken four to five h after the administration of UFH. Identified patients were categorized into two groups: BMI<30 kg/m2 or BMI ≥ 30 kg/m2. Anti-Xa heparin activity levels were then compared. Statistical analysis was performed using Student’s t-test.

Results: A total of 130 adult ICU patients were included in this study. For all critically ill patients receiving 5,000 units of subcutaneous heparin every 8 h, there was no statistically significant difference in Anti-Xa levels between the groups (p=0.287). There was no incidence of DVT/ PE reported from either group.

Conclusion: This study suggests that there is no significant difference in Anti- Xa levels between obese critically ill patients and non-obese patients receiving traditional UFH dosing for thromboprophylaxis.