Monitoring of subcutaneous dalteparin in patients with renal insufficiency under intensive care: an observational study

Journal of Critical Care
Chara KaniNina Maggina

Abstract

The objective of this study was to investigate the pharmacodynamic parameters of dalteparin in patients with renal insufficiency under intensive care. In this open, nonrandomized, nonblinded, prospective, single-dose observational study, 10 critically ill patients with renal insufficiency (mean creatinine clearance = 29.5 +/- 6.42 mL/min) were administered a single 5000-IU subcutaneous dose of dalteparin. Dalteparin blood levels were estimated indirectly over a 12-hour period by measuring anti-Xa activity and by performing a clotting assay known as the ATHU (AHEPA Thrombosis and Hemostasis Unit) test. Maximum anti-Xa activity (ie, 0.42 +/- 0.13 IU/mL) was achieved 4 hours after administration (in 8 of 10 patients). Adequate anticoagulant activity was maintained throughout the 12-hour dosage interval in all study patients. However, at time 0 hour of the study, 36 hours after the administration of a previous dose of dalteparin, considerable anti-Xa activity (ie, 0.39 +/- 0.11 IU/mL) was measured in 6 patients. A good correlation was found between anti-Xa activity and the results of the ATHU test. The presence of medium/severe edema and the concurrent administration of 1 to 3 inotropic drugs appear to contribute to a decrease in t...Continue Reading

Citations

Jul 21, 2009·Current Opinion in Pulmonary Medicine·Deborah J CookMark A Crowther
Mar 5, 2008·Critical Care : the Official Journal of the Critical Care Forum·Deborah CookUNKNOWN Canadian Critical Care Trials Group
Jun 21, 2012·Critical Care Clinics·Anita RajasekharMark A Crowther
May 27, 2008·Journal of Clinical Anesthesia·Alexander A VitinTiberiu Ezri
Dec 29, 2018·Pharmacotherapy·Paul M ReynoldsUNKNOWN Colorado Pulmonary Outcomes Research Group (CPOR)

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