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Prophylaxis Against Deep Vein Thrombosis in Critically Ill Patients With Severe Renal Insufficiency With the Low-Molecular-Weight Heparin Dalteparin

Prophylaxis Against Deep Vein Thrombosis in Critically Ill Patients With Severe Renal... ORIGINAL INVESTIGATION Prophylaxis Against Deep Vein Thrombosis in Critically Ill Patients With Severe Renal Insufficiency With the Low-Molecular-Weight Heparin Dalteparin An Assessment of Safety and Pharmacodynamics: The DIRECT Study James Douketis, MD, FRCPC; Deborah Cook, MD, MSc, FRCPC; Maureen Meade, MD, FRCPC; Gordon Guyatt, MD, FRCPC; William Geerts, MD, FRCPC; Yoanna Skrobik, MD, FRCPC; Martin Albert, MD, FRCPC; John Granton, MD, FRCPC; Paul He´bert, MD, FRCPC; Guiseppe Pagliarello, MD, FRCSC; John Marshall, MD, FRCSC; Robert Fowler, MD, FRCPC; Andreas Freitag, MD, FRCPC; Christian Rabbat, MD, FRCPC; David Anderson, MD, FRCPC; Nicole Zytaruk, MSc; Diane Heels-Ansdell, MSc; Mark Crowther, MD, MSc, FRCPC; for the Canadian Critical Care Trials Group Background: Use of low-molecular-weight heparins is tion of dalteparin exposure was 7 (4-12) days. In 120 pa- avoided in patients with renal insufficiency because of con- tients who had at least 1 trough anti-Xa level (427 total cerns about an excessive anticoagulant effect and in- measurements), no patient had bioaccumulation (0%; 95% creased bleeding risk. To challenge this premise, we evalu- confidence interval [CI]: 0%-3.0%); the median (IQR) ated if deep vein thrombosis (DVT) prophylaxis with trough anti-Xa level was undetectable (0.10 IU/mL dalteparin sodium confers an excessive anticoagulant effect [0.10 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Prophylaxis Against Deep Vein Thrombosis in Critically Ill Patients With Severe Renal Insufficiency With the Low-Molecular-Weight Heparin Dalteparin

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References (47)

Publisher
American Medical Association
Copyright
Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/archinte.168.16.1805
pmid
18779469
Publisher site
See Article on Publisher Site

Abstract

ORIGINAL INVESTIGATION Prophylaxis Against Deep Vein Thrombosis in Critically Ill Patients With Severe Renal Insufficiency With the Low-Molecular-Weight Heparin Dalteparin An Assessment of Safety and Pharmacodynamics: The DIRECT Study James Douketis, MD, FRCPC; Deborah Cook, MD, MSc, FRCPC; Maureen Meade, MD, FRCPC; Gordon Guyatt, MD, FRCPC; William Geerts, MD, FRCPC; Yoanna Skrobik, MD, FRCPC; Martin Albert, MD, FRCPC; John Granton, MD, FRCPC; Paul He´bert, MD, FRCPC; Guiseppe Pagliarello, MD, FRCSC; John Marshall, MD, FRCSC; Robert Fowler, MD, FRCPC; Andreas Freitag, MD, FRCPC; Christian Rabbat, MD, FRCPC; David Anderson, MD, FRCPC; Nicole Zytaruk, MSc; Diane Heels-Ansdell, MSc; Mark Crowther, MD, MSc, FRCPC; for the Canadian Critical Care Trials Group Background: Use of low-molecular-weight heparins is tion of dalteparin exposure was 7 (4-12) days. In 120 pa- avoided in patients with renal insufficiency because of con- tients who had at least 1 trough anti-Xa level (427 total cerns about an excessive anticoagulant effect and in- measurements), no patient had bioaccumulation (0%; 95% creased bleeding risk. To challenge this premise, we evalu- confidence interval [CI]: 0%-3.0%); the median (IQR) ated if deep vein thrombosis (DVT) prophylaxis with trough anti-Xa level was undetectable (0.10 IU/mL dalteparin sodium confers an excessive anticoagulant effect [0.10

Journal

JAMA Internal Medicine – American Medical Association

Published: Sep 8, 2008

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