Piagnerelli Michaël, Cauchie Philippe, Vancutsem Maxime, Thooft Aurélie, Zouaoui Boudjeltia Karim, Biston Patrick, Wautrecht Jean-Claude
Intensive Care, CHU-Charleroi Marie-Curie, Université Libre de Bruxelles, Charleroi, Belgium, and Experimental Medicine Laboratory, CHU-Charleroi, ULB 222 Unit, Université Libre de Bruxelles, Montigny-le-Tilleul, Belgium.
Clinical Biology, Department of Hematology, CHU-Charleroi Marie-Curie, Université Libre de Bruxelles, Charleroi, Belgium.
Crit Care Explor. 2020 Jul 29;2(8):e0177. doi: 10.1097/CCE.0000000000000177. eCollection 2020 Aug.
It is now reported that coronavirus disease 2019 ICU patients are at increased risk of thrombosis. Expert opinion and scientific societies recommend a higher dose of low-molecular-weight heparin, but definitive data is lacking. We report our adapted thromboprophylaxis practice of low-molecular-weight heparin administration in coronavirus disease 2019 ICU patients. One-hundred six measurements in 19 ICU patients were collected. Despite enoxaparin 60 mg once daily, only two measurements of the trough anti-Xa were in the upper end of prophylactic range. Anti-Xa activity peaks increased significantly after administration, but all measurements were under the optimal prophylactic ranges. Despite an adapted protocol, three of the 19 patients (16%) developed venous thromboembolism. We show in coronavirus disease 2019 ICU patients, despite higher prophylactic low-molecular-weight heparin administration due to body mass index, anti-Xa activity was well below peak serum levels in our cohort of critically ill coronavirus disease 2019 patients. This evaluation suggests the need for rapid studies on adequate thromboprophylaxis in these patients.
据报道，2019冠状病毒病重症监护病房（ICU）患者发生血栓形成的风险增加。专家意见和科学协会建议使用更高剂量的低分子量肝素，但缺乏确凿的数据。我们报告了我们在2019冠状病毒病ICU患者中调整后的低分子量肝素血栓预防措施。收集了19例ICU患者的106次测量数据。尽管每天一次给予60毫克依诺肝素，但只有两次谷值抗Xa测量值处于预防范围的上限。给药后抗Xa活性峰值显著增加，但所有测量值均低于最佳预防范围。尽管采用了调整后的方案，19例患者中有3例（16%）发生了静脉血栓栓塞。我们发现，在2019冠状病毒病ICU患者中，尽管由于体重指数而给予了更高剂量的预防性低分子量肝素，但在我们这组重症2019冠状病毒病患者中，抗Xa活性远低于血清峰值水平。该评估表明需要对这些患者进行充分血栓预防的快速研究。
