Utilization of Venous Thromboembolism Prophylaxis in the Medical Intensive Care Unit

CHEST Journal ◽  
1994 ◽  
Vol 106 (1) ◽  
pp. 13-14 ◽  
Author(s):  
Martin G. Keane ◽  
Edward P. Ingenito ◽  
Samuel Z. Goldhaber
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Venous Thromboembolism ◽  
Medical Intensive Care Unit ◽  
Thromboembolism Prophylaxis ◽  
Venous Thromboembolism Prophylaxis ◽  
Medical Intensive Care

scholarly journals Does Obesity Predispose Medical Intensive Care Unit Patients to Venous Thromboembolism despite Prophylaxis? A Retrospective Chart Review

2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Bradley J. Peters ◽  
Ross A. Dierkhising ◽  
Kristin C. Mara
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Venous Thromboembolism ◽  
Risk Model ◽  
Medical Intensive Care Unit ◽  
Statistical Significance ◽  
The Body ◽  
Vte Prophylaxis ◽  
Increased Risk ◽  
Medical Intensive Care

Background. Obesity is a significant issue in the critically ill population. There is little evidence directing the dosing of venous thromboembolism (VTE) prophylaxis within this population. We aimed to determine whether obesity predisposes medical intensive care unit patients to venous thromboembolism despite standard chemoprophylaxis with 5000 international units of subcutaneous heparin three times daily. Results. We found a 60% increased risk of venous thromboembolism in the body mass index (BMI) ≥ 30 kg/m2 group compared to the BMI < 30 kg/m2 group; however, this difference did not reach statistical significance. After further utilizing our risk model, neither obesity nor mechanical ventilation reached statistical significance; however, vasopressor administration was associated with a threefold risk. Conclusions. We can conclude that obesity did increase the rate of VTE, but not to a statistically significant level in this single center medical intensive care unit population.

scholarly journals Venous Thromboembolism in the Medical Intensive Care Unit. Is Wells Score Predictive?

CHEST Journal ◽  
2012 ◽  
Vol 142 (4) ◽  
pp. 856A
Author(s):  
Trupti Vakde ◽  
Ajit Lale ◽  
Misbahuddin Khaja ◽  
Gilda Diaz-Fuentes ◽  
Sindhaghatta Venkatram
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Venous Thromboembolism ◽  
Medical Intensive Care Unit ◽  
Wells Score ◽  
Medical Intensive Care

Standard Dosing of Enoxaparin for Venous Thromboembolism Prophylaxis is Not Sufficient for Most Patients within a Trauma Intensive Care Unit

2015 ◽  
Vol 81 (9) ◽  
pp. 889-892 ◽  
Author(s):  
Jack W. Rostas ◽  
Sidney B. Brevard ◽  
Naveed Ahmed ◽  
John Allen ◽  
Derek Thacker ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Venous Thromboembolism ◽  
Abdominal Wall ◽  
Wall Thickness ◽  
Fluid Balance ◽  
Obese Patients ◽  
Thromboembolism Prophylaxis ◽  
Venous Thromboembolism Prophylaxis ◽  
Subcutaneous Enoxaparin

Recent reports confirm that the standard dose of enoxaparin in obese patients is often subtherapeutic, leading to a higher incidence of venous thromboembolism. All patients receiving subcutaneous enoxaparin 30 mg twice a day (b.i.d.) for venous thromboembolism prophylaxis were prospectively enrolled in this study. Trough antiXa levels were obtained and any level less than 0.1 IU/mL was considered subtherapeutic and the final dosage requirement was recorded. Body mass index (BMI), abdominal wall thickness, and fluid balance were collected. Thirty-four patients were prospectively enrolled in the study, 14 (50%) of which had a BMI >30. Sixty-five per cent of obese patients were initially nontherapeutic, compared with 53 per cent of the nonobese ( P = 0.73). However, elevated BMI ( P < 0.05) and abdominal wall thickness ( P < 0.05) correlated to an increased final dose required to attain an anti Xa ≥0.1 when not initially therapeutic, whereas fluid balance demonstrated no correlation ( P = 0.232). Subcutaneous enoxaparin dosing of 30 mg b.i.d. is not sufficient for the majority adult trauma patients in the intensive care unit, regardless of BMI. When enoxaparin 30 mg b.i.d. is initially subtherapeutic, obese patients may require a larger dose necessary to achieve necessary anticoagulation.

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