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@article{1618917,
author = {Cihlář, Radek and Šrámek, Vladimír and Papiež, Adriána and Penka, Miroslav and Suk, Pavel},
article_location = {BASEL},
article_number = {1-2},
doi = {http://dx.doi.org/10.1159/000502847},
keywords = {Low molecular weight heparin; Pharmacokinetics; Anti-factor Xa activity; Thromboembolism; Prophylaxis; Vasopressors},
language = {eng},
issn = {0031-7012},
journal = {PHARMACOLOGY},
title = {Pharmacokinetic Comparison of Subcutaneous and Intravenous Nadroparin Administration for Thromboprophylaxis in Critically Ill Patients on Vasopressors},
url = {https://www.karger.com/Article/FullText/502847},
volume = {105},
year = {2020}
}
TY - JOUR
ID - 1618917
AU - Cihlář, Radek - Šrámek, Vladimír - Papiež, Adriána - Penka, Miroslav - Suk, Pavel
PY - 2020
TI - Pharmacokinetic Comparison of Subcutaneous and Intravenous Nadroparin Administration for Thromboprophylaxis in Critically Ill Patients on Vasopressors
JF - PHARMACOLOGY
VL - 105
IS - 1-2
SP - 73-78
EP - 73-78
PB - KARGER
SN - 00317012
KW - Low molecular weight heparin
KW - Pharmacokinetics
KW - Anti-factor Xa activity
KW - Thromboembolism
KW - Prophylaxis
KW - Vasopressors
UR - https://www.karger.com/Article/FullText/502847
L2 - https://www.karger.com/Article/FullText/502847
N2 - Introduction: Critically ill patients are exposed to a high risk of developing thromboembolism. Moreover, standard prophylaxis with subcutaneous (SC) heparin is less efficient in patients requiring vasopressors. The aim is a comparison of pharmacokinetics between SC and intravenous (IV) applied nadroparin. Methods: Thirty-eight ventilated ICU patients requiring vasopressor support were randomized into a single dose of nadroparin 3,800 IU (0.4 mL) subcutaneously (SC group) or 1,900 IU (0.2 mL) intravenously (IV group). Anti-factor Xa activity (anti-Xa) was observed over 24 h; data are stated as median (IQR). Results: Peak anti-Xa was significantly higher in the IV group 0.42 (0.39-0.43) IU/mL than in the SC group 0.16 (0.09-0.18) IU/mL (p < 0.001). There was a trend towards higher area under the curve (AUC) of anti-Xa in the SC group 1.41 (0.41-1.80) IU/mL x h than in the IV group 1.04 (0.93-1.13) IU/mL x h (p = 0.08). In the SC group, there was a negative correlation between anti-Xa AUC and both capillary refill time Xa (r = -0.86) and norepinephrine dose (r = -0.68). In the IV group, anti-Xa decrease half-life was 1.6 (1.4-2.0) h. Conclusions: IV administration of 1,900 IU of nadroparin led to a predictable effective peak anti-Xa. After SC administration, anti-Xa was heterogeneous and significantly influenced by peripheral perfusion.
ER -
CIHLÁŘ, Radek, Vladimír ŠRÁMEK, Adriána PAPIEŽ, Miroslav PENKA a Pavel SUK. Pharmacokinetic Comparison of Subcutaneous and Intravenous Nadroparin Administration for Thromboprophylaxis in Critically Ill Patients on Vasopressors. \textit{PHARMACOLOGY}. BASEL: KARGER, 2020, roč.~105, 1-2, s.~73-78. ISSN~0031-7012. Dostupné z: https://dx.doi.org/10.1159/000502847.
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