Venous Thromboembolism in Coagulopathic Surgical Intensive Care Unit Patients: Is There a Benefit From Chemical Prophylaxis?

2011 ◽  
Vol 70 (6) ◽  
pp. 1398-1400 ◽  
Author(s):  
Meghan Edwards ◽  
Seth Felder ◽  
Eric Ley ◽  
Marissa Srour ◽  
James Mirocha ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Venous Thromboembolism ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Chemical Prophylaxis

Implementation of an Enoxaparin Protocol for Venous Thromboembolism Prophylaxis in Obese Surgical Intensive Care Unit Patients

2011 ◽  
Vol 45 (11) ◽  
pp. 1356-1362 ◽  
Author(s):  
Kyle P Ludwig ◽  
Heidi J Simons ◽  
Mary Mone ◽  
Richard G Barton ◽  
Edward J Kimball
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Venous Thromboembolism ◽  
Factor Xa ◽  
Major Surgery ◽  
Surgical Intensive Care Unit ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Surgical Intensive Care ◽  
Vte Prophylaxis

Background:: Venous thromboembolism (VTE) is a serious health care issue that affects a large number of people. Few standards exist for delineating the optimal dosing strategy for VTE prevention in obese patients, especially in the setting of major surgery or trauma. Objective: To document the efficacy of a surgical intensive care unit (SICU)–specific, weight-based dosing protocol of enoxaparin 0.5 mg/kg given subcutaneously every 12 hours for VTE prophylaxis in morbidly obese (defined as body mass index [BMI] ≥35 kg/m2 or weight ≥150 kg) SICU patients, using peak anti-factor Xa levels to determine therapeutic endpoints. Methods: Data were collected retrospectively in an academic, university-based SICU on 23 morbidly obese patients who received weight-based enoxaparin for VTE prophylaxis from December 1, 2008, through June 30, 2010. Results: A weight-based dosage range of enoxaparin 50-120 mg twice daily (median 60) was given to 23 patients. The mean BMI was 46.4 kg/m2. The initial mean anti-factor Xa level (measured after the third dose) was 0.34 IU/mL (range 0.20-0.59). Patients received an average of 18 doses. Two cases required an increase or decrease in dosage based on anti-factor Xa levels. Morbidity related to this dosing included a single event of minor endotracheal bleeding and a single deep vein thrombosis that was likely present prior to treatment. Conclusions: Weight-based dosing with enoxaparin in morbidly obese SICU patients was effective in achieving anti-factor Xa levels within the appropriate prophylactic range. This regimen reduced the rate of VTE below expected levels and no additional adverse effects were reported.

OC76 THE MORE PROCEDURE (MININVASIVE, OPCAB, RAPID SURGICAL INTENSIVE CARE UNIT EXIT, EXTUBATION INTO THE OPERATING ROOM)

2018 ◽  
Vol 19 ◽  
pp. e26
Author(s):  
M. Colombino ◽  
A. Longobardi ◽  
A. Panza ◽  
G. Mastrogiovanni ◽  
P. Masiello ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Operating Room ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care
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