Helviz Yigal, Dzigivker Ilia, Raveh-Brawer David, Hersch Moshe, Zevin Shoshana, Einav Sharon
Isr Med Assoc J. 2016 Feb;18(2):108-13.
Enoxaparin is frequently used as prophylaxis for deep venous thrombosis in critically ill patients.
To evaluate three enoxaparin prophylactic regimens in critical care patients with and without administration of a vasopressor.
Patients admitted to intensive care units (general and post-cardiothoracic surgery) without renal failure received, once daily, a subcutaneous fixed dose of 40 mg enoxaparin, a subcutaneous dose of 0.5 mg/kg enoxaparin, or an intravenous dose of 0.5 mg/kg enoxaparin. Over 5 days anti-activated factor X levels were collected before the daily administration and 4 hours after the injection.
Overall, 16 patients received the subcutaneous fixed dose, 15 received the subcutaneous weight-based dosage, and 8 received the dose intravenously. Around two-fifths (38%) of the patients received vasopressors. There was no difference between anti-activated factor X levels regarding vasopressor administration. However, in all three groups the levels were outside the recommended range of 0.1 IU/ml and 0.3 IU/ml.
Although not influenced by vasopressor administration, the enoxaparin regimens resulted in blood activity levels outside the recommended range.
依诺肝素常用于危重症患者深静脉血栓的预防。
评估三种依诺肝素预防方案在使用和未使用血管升压药的重症监护患者中的效果。
入住重症监护病房（普通病房和心胸外科术后病房）且无肾衰竭的患者，每天接受一次皮下固定剂量40mg依诺肝素、皮下剂量0.5mg/kg依诺肝素或静脉剂量0.5mg/kg依诺肝素。在5天内，每天给药前及注射后4小时采集抗活化X因子水平。
总体而言，16例患者接受皮下固定剂量，15例接受皮下按体重给药，8例接受静脉给药。约五分之二（38%）的患者接受了血管升压药治疗。血管升压药的使用对抗活化X因子水平没有影响。然而，所有三组的水平均超出了推荐范围0.1IU/ml至0.3IU/ml。
尽管不受血管升压药使用的影响，但依诺肝素方案导致血液活性水平超出推荐范围。
