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Updated: May 23, 2026
05:52
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
[Pharmacologic thromboprophylaxis in critically ill patients]
1Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum. andreas.loew@charite.de
Summary
Critical care patients require anticoagulant prophylaxis to prevent thromboembolic events. Unfractionated heparin, low-molecular-weight heparin, and fondaparinux are safe and effective, while argatroban is suitable for heparin-induced thrombocytopenia.
Area of Science:
- Critical care medicine
- Pharmacology
- Thrombosis research
Context:
- Critical care patients face high risk of thromboembolic events.
- Established guidelines recommend pharmacologic anticoagulant prophylaxis.
- Limited data exists for optimal drug selection and dosing in this population.
Purpose:
- To review current evidence on anticoagulant prophylaxis in critical care.
- To discuss safe and effective anticoagulant options for high-risk patients.
- To address uncertainties regarding drug choice and optimal dosages.
Summary:
- Prophylactic use of unfractionated heparin (UFH), low-molecular-weight heparin (LMWH), and fondaparinux is safe and effective in critical care.
- Argatroban is a suitable option for anticoagulation in cases of suspected or diagnosed heparin-induced thrombocytopenia (HIT) type II.
- Newer oral anticoagulants are not currently indicated for intensive care unit (ICU) patients.
Impact:
- Provides guidance on anticoagulant selection for critical care settings.
- Highlights the efficacy and safety of established prophylactic agents.
- Identifies areas needing further research regarding anticoagulation in critically ill patients.
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