Plasma anti-FXa level as a surrogate marker of the adequacy of thromboprophylaxis in critically ill patients : A systematic review

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Vahtera , A , Vaara , S , Pettila , V & Kuitunen , A 2016 , ' Plasma anti-FXa level as a surrogate marker of the adequacy of thromboprophylaxis in critically ill patients : A systematic review ' Thrombosis Research , vol. 139 , pp. 10-16 . DOI: 10.1016/j.thromres.2015.12.016

Title: Plasma anti-FXa level as a surrogate marker of the adequacy of thromboprophylaxis in critically ill patients : A systematic review
Author: Vahtera, Annukka; Vaara, Suvi; Pettila, Ville; Kuitunen, Anne
Contributor: University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Department of Diagnostics and Therapeutics
Date: 2016-03
Language: eng
Number of pages: 7
Belongs to series: Thrombosis Research
ISSN: 0049-3848
URI: http://hdl.handle.net/10138/160830
Abstract: Background: Critical care patients are prone to venous thromboembolism (VTE) and, thus, pharmacological thromboprophylaxis is generally advised. Low-molecular weight heparins (LMWHs) have become the drug of choice in ICU patients, since their predictable and reproducible dose response. Monitoring their pharmacological effect is not usually necessary except in special occasions (i.e. with obese or renal failure patients), where anti-FXa level measuring is recommended. However, there is neither recommendation of adequate anti-FXa levels in critically ill patients nor is it known whether peak or trough level should be measured. The aim of this systematic review was to evaluate the recommended LMWH doses, and the reasons to monitor anti-FXa levels. Methods: We searched MEDLINE, Scopus, Cochrane Central Register of Controlled Trials and ClinicalTrials.com to identify all potentially relevant studies. Prospective studies done in critically ill patients were included if at least one anti-FXa level (i.e. peak or trough) after any specified LMWH thromboprophylaxis dose was measured. Results: Total 18 eligible studies including 1644 patients were included. There was a wide variation in the median peak anti-FXa levels ( Conclusion: Based on the current literature, no definite conclusions can be drawn on targeted anti-FXa level in critically ill patients when using LMWH thromboprophylaxis. (C) 2016 Elsevier Ltd. All rights reserved.
Subject: Anti-FXa
Critical care
LMWH
Thromboprophylaxis
Monitoring
MOLECULAR-WEIGHT HEPARIN
DEEP-VEIN THROMBOSIS
SEVERE RENAL-INSUFFICIENCY
ANTIFACTOR-XA ACTIVITY
SURGICAL-PATIENTS
TRAUMA PATIENTS
UNFRACTIONATED HEPARIN
VENOUS THROMBOEMBOLISM
HIP-REPLACEMENT
ENOXAPARIN
3121 Internal medicine
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