Anti Xa activity after high dose LMWH thrombosis prophylaxis in covid 19 patients at the intensive care unit
Copyright © 2020. Published by Elsevier Ltd..
INTRODUCTION: Coagulopathy in Coronavirus disease 2019 (covid-19) has been demonstrated by an increase in D-dimer, prothrombin time (PT), fibrinogen and factor VIII. Venous thromboembolic events are a common abnormality in patients with covid-19. We evaluate the results of intensive care unit (ICU) thrombosis prophylaxis of 5700 international unit (IU) nadroparin low molecular weight heparin (LMWH) twice daily.
METHODS: After introduction of this high-dose pharmacological thrombosis prophylaxis twice weekly anti-factor Xa (anti Xa) concentrations and results from routine laboratory and viscoelastic hemostatic tests in 16 ICU covid-19 patients were evaluated.
RESULTS: During one week, median peak anti Xa activities were 0.38 [0.16-0.45] and 0.38 [0.20-0.58] at time point 1 and 2 respectively. Laboratory coagulation tests showed PT, AT and platelet count (PltC) values within normal range and markedly increased D-dimer and fibrinogen levels. Viscoelastic tests showed a maximum clot strength just above normal reference value, while fibrin clot strength was strongly increased. The overall contribution of fibrin to clot strength was high with 71 [56-85]%.
CONCLUSION: Anti Xa activity was within the target range of pharmacodynamic endpoint for covid-19 patients but viscoelastic tests still demonstrated a procoagulant pattern.
| Errataetall: |
CommentOn: Thromb Res. 2020 Jul;191:145-147. - PMID 32291094 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:196 |
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| Enthalten in: |
Thrombosis research - 196(2020) vom: 15. Dez., Seite 1-3 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Vlot, E A [VerfasserIn] |
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| Links: |
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| Themen: |
Anti Xa activity |
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| Anmerkungen: |
Date Completed 04.12.2020 Date Revised 19.01.2021 published: Print-Electronic CommentOn: Thromb Res. 2020 Jul;191:145-147. - PMID 32291094 Citation Status MEDLINE |
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| doi: |
10.1016/j.thromres.2020.07.035 |
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| PPN (Katalog-ID): |
NLM313801924 |
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| 500 | |a Date Revised 19.01.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentOn: Thromb Res. 2020 Jul;191:145-147. - PMID 32291094 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020. Published by Elsevier Ltd. | ||
| 520 | |a INTRODUCTION: Coagulopathy in Coronavirus disease 2019 (covid-19) has been demonstrated by an increase in D-dimer, prothrombin time (PT), fibrinogen and factor VIII. Venous thromboembolic events are a common abnormality in patients with covid-19. We evaluate the results of intensive care unit (ICU) thrombosis prophylaxis of 5700 international unit (IU) nadroparin low molecular weight heparin (LMWH) twice daily | ||
| 520 | |a METHODS: After introduction of this high-dose pharmacological thrombosis prophylaxis twice weekly anti-factor Xa (anti Xa) concentrations and results from routine laboratory and viscoelastic hemostatic tests in 16 ICU covid-19 patients were evaluated | ||
| 520 | |a RESULTS: During one week, median peak anti Xa activities were 0.38 [0.16-0.45] and 0.38 [0.20-0.58] at time point 1 and 2 respectively. Laboratory coagulation tests showed PT, AT and platelet count (PltC) values within normal range and markedly increased D-dimer and fibrinogen levels. Viscoelastic tests showed a maximum clot strength just above normal reference value, while fibrin clot strength was strongly increased. The overall contribution of fibrin to clot strength was high with 71 [56-85]% | ||
| 520 | |a CONCLUSION: Anti Xa activity was within the target range of pharmacodynamic endpoint for covid-19 patients but viscoelastic tests still demonstrated a procoagulant pattern | ||
| 650 | 4 | |a Letter | |
| 650 | 4 | |a Comment | |
| 650 | 4 | |a Anti Xa activity | |
| 650 | 4 | |a Covid-19 | |
| 650 | 4 | |a Thrombosis prophylaxis management | |
| 650 | 4 | |a Viscoelastic coagulation tests | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 650 | 7 | |a Heparin, Low-Molecular-Weight |2 NLM | |
| 700 | 1 | |a Van den Dool, E J |e verfasserin |4 aut | |
| 700 | 1 | |a Hackeng, C M |e verfasserin |4 aut | |
| 700 | 1 | |a Sohne, M |e verfasserin |4 aut | |
| 700 | 1 | |a Noordzij, P G |e verfasserin |4 aut | |
| 700 | 1 | |a Van Dongen, E P A |e verfasserin |4 aut | |
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