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低分子量肝素 (埃诺沙巴林) 给药的基于体重的剂量,以实现创伤患者的最佳静脉瘤预防

Tarendeep Thind¹, Thomas Heye¹, Curran Henson¹

¹College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

The American surgeon

|March 22, 2024

概括

与固定剂量相比,低分子量肝素 (LMWH) 的基于体重的剂量改善了创伤患者的治疗抗Xa水平. 这表明基于体重的剂量可能是静脉血栓塞栓症预防的更有效策略.

科学领域:

创伤外科手术创伤外科
药理学药理学是指药理学的学科.
临界护理医学临界护理医学

背景情况:

创伤伤害增加了静脉血栓栓塞 (VTE) 的风险.
低分子量肝素 (LMWH) 是一种常见的静脉瘤预防药物,但最佳剂量尚不清楚.
这项研究比较了创伤患者的固定和基于体重的LMWH剂量.

研究的目的:

为了比较固定剂量与基于体重的LMWH剂量的VTE预防疗法的疗效.
为了确定哪种剂量策略更一致地达到治疗性抗Xa水平.

主要方法:

追溯队列研究,比较固定和基于体重的LMWH剂量策略.
纳入标准:创伤患者的eGFR>30mL/min/1.73m2,≥3个LMWH剂量,以及初始的抗Xa水平.
固定剂量: 30 mg LMWH SC BID; 根据体重: 0.5 mg/kg (最大 60 mg) SC q12h; 目标抗Xa: 0.20.4 IU/mL.

主要成果:

基于体重的剂量组 (WBDG,n=874) 在66.5%的患者中实现了目标抗Xa水平,而固定剂量组 (FDG,n=817) 的这一比例为42.8%.
与FDG相比,WBDG的治疗次 (23.5%与54.1%) 和治疗次 (10.1%与3.1%) 的水平较少.
剂量策略显著影响了抗Xa水平的分布 (P < .001);血液产品输血率没有差异.

结论:

基于体重的LMWH剂量优于固定剂量,用于在创伤患者中达到目标抗Xa水平.
需要进一步的大规模研究来评估与每个策略相关的静脉瘤发作事件和出血风险.

关键词:

洛文诺克斯 (Lovenox) 公司出血并发症出血并发症创伤患者创伤患者静脉血栓塞栓症预防预防

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