Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Adequate thromboprophylaxis in critically ill patients. | Levi Critical Care 2010 14 142 http content 14 2 142 CRITICAL CARE COMMENTARY L__ Adequate thromboprophylaxis in critically ill patients Marcel Levi See related research by Robinson etal. http content 14 2 R41 Abstract Venous thromboembolism is a relatively frequently occurring complication in critically ill patients admitted to the ICU despite prophylactic treatment with subcutaneous low molecular weight heparin. Several studies show that critically ill patients have significantly lower plasma anti-factor-Xa activity levels compared to control patients after administration of subcutaneous heparin. Robinson and colleagues show in this issue of Critical Care dose-dependent but relatively low levels of anti-factor Xa activity at increasing doses of enoxaparin. Anti-factor Xa levels thought to be required for adequate thromboprophylaxis are observed only at doses of enoxaparin that are one and a half times higher than the conventional dose 40 mg . In this issue of Critical Care Robinson and colleagues 1 investigate the effect of increasing doses of the low molecular weight LMW heparin enoxaparin commonly used as prophylaxis against venous thromboembolism VTE on systemic heparin concentrations expressed as anti-factor Xa levels. VTE is a common complication in critically ill patients. Reported rates for deep venous thrombosis in patients admitted to the ICU range from 22 to 80 depending on patient characteristics. Thromboprophylaxis with unfractionated or LMW heparin lowers the risk for deep venous thrombosis by more than 50 2 . Nevertheless the risk of VTE in critically ill patients receiving LMW heparin prophylaxis is still much higher than in other patient groups. Amongst several factors that may explain the higher incidence of VTE in critically ill patients such as full immobilisation or withholding anticoagulant prophylaxis because of a high bleeding risk it was hypothesized that Correspondence Department of .
