Antifactor Xa Levels in Critically Ill Korean Patients Receiving Enoxaparin for Thromboprophylaxis: A Prospective Observational Study.
10.3346/jkms.2013.28.3.466
- Author:
So Yeon LIM
1
;
Kyeongman JEON
;
Hee Jin KIM
;
Seon Mi KIM
;
Junwhi SONG
;
Jung Min HA
;
Sang Won UM
;
Won Jung KOH
;
Man Pyo CHUNG
;
Hojoong KIM
;
O Jung KWON
;
Gee Young SUH
Author Information
1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. suhgy@skku.edu
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Asia;
Enoxaparin;
Factor Xa;
Intensive Care Units;
Venous Thrombosis
- MeSH:
Aged;
Asian Continental Ancestry Group;
Critical Illness;
Enoxaparin/*therapeutic use;
Factor Xa/analysis/*antagonists & inhibitors;
Female;
Fibrinolytic Agents/*therapeutic use;
Humans;
Hyperbilirubinemia/metabolism;
Intensive Care Units;
Male;
Middle Aged;
Odds Ratio;
Prospective Studies;
Regression Analysis;
Republic of Korea;
Risk Factors;
Venous Thromboembolism/*drug therapy
- From:Journal of Korean Medical Science
2013;28(3):466-471
- CountryRepublic of Korea
- Language:English
-
Abstract:
The aim of this study was to investigate antifactor Xa (aFXa) levels after once daily dose of 40 mg of enoxaparin and to evaluate factors influencing aFXa levels among Korean intensive care unit (ICU) patients. This prospective observational study was conducted between August and December 2011 in medical ICUs at Samsung Medical Center. AFXa levels between 0.1 and 0.3 U/mL were considered to be effective for antithrombotic activity. Fifty-five patients were included. The median aFXa levels were 0.22 (IQR 0.17-0.26) at 4 hr, 0.06 (IQR 0.02-0.1) at 12 hr, and 0 U/mL (IQR 0-0.03) at 24 hr. The numbers of patients showing effective antithrombotic aFXa levels were 48 (87.3%), 18 (32.7%), and 0 (0%) at 4, 12 and 24 hr, respectively. At 12 hr, higher sequential organ failure assessment (SOFA) scores and hyperbilirubinemia were significantly associated with low aFXa levels (OR, 0.58; 95% CI, 0.36-0.93; P = 0.02 and 0.06; 0.003-0.87; 0.04, respectively). Once daily dose of 40 mg of enoxaparin is inadequate for maintaining effective antithrombotic aFXa levels, and the inadequacy is more salient for patients with high SOFA scores and hyperbilirubinemia.
