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Venous Thromboembolism Prophylaxis in Low Body Weight Critically Ill Patients.
Knox, Helena; Edwin, Stephanie B; Giuliano, Christopher; Paxton, Renee Alexander.
Afiliación
  • Knox H; Department of Pharmacy, Ascension St. John Hospital, Detroit, MI, USA.
  • Edwin SB; Department of Pharmacy, Ascension St. John Hospital, Detroit, MI, USA.
  • Giuliano C; Department of Pharmacy, Ascension St. John Hospital, Detroit, MI, USA.
  • Paxton RA; Department of Pharmacy, Wayne State University, Eugene Applebaum Applebaum College of Pharmacy and Health Sciences, Detroit, MI, USA.
J Intensive Care Med ; 39(5): 493-498, 2024 May.
Article en En | MEDLINE | ID: mdl-38111295
ABSTRACT

OBJECTIVE:

To compare bleeding and thromboembolic events in low body weight patients receiving reduced-dose venous thromboembolism (VTE) prophylaxis versus standard-dose VTE prophylaxis.

DESIGN:

Multicenter, retrospective, cohort study.

SETTING:

Five Ascension Health Hospitals. PATIENTS Adult, critically ill, low body weight (≤50 kg) patients who received either reduced-dose VTE prophylaxis (n = 140) or standard-dose VTE prophylaxis (n = 279) for at least 48 h. INTERVENTION Reduced-dose prophylaxis (enoxaparin 30 mg daily or heparin 5000 units every 12 h subcutaneously) or standard-dose prophylaxis (enoxaparin 40 mg daily, enoxaparin 30 mg every 12 h, or heparin 5000 units every 8 h subcutaneously). MEASUREMENTS AND MAIN

RESULTS:

A total of 419 patients were included with a mean weight of 45.1 ± 4.2 kg in the standard-dose group and 44.0 ± 5.1 kg in the reduced-dose prophylaxis group (P = .02). The primary endpoint, composite bleeding, was significantly lower in patients receiving reduced-dose prophylaxis (5% vs 12.5%, P = .02). After adjusting for confounding factors, results remained consistent demonstrating reduced composite bleeding with reduced-dose prophylaxis (odds ratio 0.36, 95% confidence interval 0.14-0.96). Major bleeding events occurred in 3.6% of reduced-dose patients compared with 8.6% in standard-dose patients (P = .056). Clinically relevant nonmajor bleeding (5.4% vs 2.9%, P = .24) and VTE (2.2% vs 0%, P = .08) events were similar between groups.

CONCLUSIONS:

A reduced-dose VTE prophylaxis strategy in low body weight, critically ill patients was associated with a lower risk of composite bleeding and similar rate of thromboembolism.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enoxaparina / Tromboembolia Venosa Límite: Adult / Humans Idioma: En Revista: J Intensive Care Med Asunto de la revista: TERAPIA INTENSIVA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enoxaparina / Tromboembolia Venosa Límite: Adult / Humans Idioma: En Revista: J Intensive Care Med Asunto de la revista: TERAPIA INTENSIVA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos