Jenkins Randi, Sheth Sahil, Nestor Breanne, Mazer Adrien
Department of Pharmacy Services, Anne Arundel Medical Center, Annapolis, Maryland.
Department of Critical Care Medicine, Anne Arundel Medical Center, Annapolis, Maryland.
Innov Pharm. 2021 Jun 10;12(3). doi: 10.24926/iip.v12i3.3835. eCollection 2021.
To assess the impact of therapeutic dose versus prophylactic dose anticoagulation regimens on outcomes in mechanically ventilated patients with COVID-19. Of the 121 mechanically ventilated patients with COVID-19, 33 in the therapeutic-dose group and 34 patients in the prophylactic-dose group were included in the final analysis. The therapeutic-dose group had a decreased 14-day mortality compared to the prophylaxis dose group (9.1% vs 41.2%, p=0.004). In addition, 30-day mortality was also lower in the therapeutic anticoagulation group (24.2% vs. 52.9%, p=0.024). A longer hospital LOS (45.7 vs 26 days, p=0.003) and duration of mechanical ventilation (33.9 vs 13.3 days, p<0.001) were observed in patients on therapeutic anticoagulation in comparison to the prophylaxis dosing group. A higher rate of major bleeding was observed in patients who received therapeutic anticoagulation. In this analysis of mechanically ventilated COVID-19 patients in the ICU, therapeutic dose anticoagulation was associated with a significantly lower 14-day mortality, but increased bleeding.
评估治疗剂量与预防剂量抗凝方案对新型冠状病毒肺炎（COVID-19）机械通气患者预后的影响。在121例COVID-19机械通气患者中，最终分析纳入了治疗剂量组的33例患者和预防剂量组的34例患者。与预防剂量组相比，治疗剂量组的14天死亡率降低（9.1%对41.2%，p=0.004）。此外，治疗性抗凝组的30天死亡率也较低（24.2%对52.9%，p=0.024）。与预防给药组相比，接受治疗性抗凝的患者住院时间更长（45.7天对26天，p=0.003），机械通气时间更长（33.9天对13.3天，p<0.001）。接受治疗性抗凝的患者大出血发生率更高。在对重症监护病房（ICU）中COVID-19机械通气患者的这项分析中，治疗剂量抗凝与显著降低的14天死亡率相关，但出血增加。
