Pharmacokinetic Comparison of Subcutaneous and Intravenous
Nadroparin Administration for Thromboprophylaxis in Critically
Ill Patients on Vasopressors

J 2020

Pharmacokinetic Comparison of Subcutaneous and Intravenous Nadroparin Administration for Thromboprophylaxis in Critically Ill Patients on Vasopressors

CIHLÁŘ, Radek, Vladimír ŠRÁMEK, Adriána PAPIEŽ, Miroslav PENKA, Pavel SUK et. al.

Základní údaje

Originální název

Pharmacokinetic Comparison of Subcutaneous and Intravenous Nadroparin Administration for Thromboprophylaxis in Critically Ill Patients on Vasopressors

Autoři

CIHLÁŘ, Radek (203 Česká republika, domácí), Vladimír ŠRÁMEK (203 Česká republika, domácí), Adriána PAPIEŽ (703 Slovensko, domácí), Miroslav PENKA (203 Česká republika, domácí) a Pavel SUK (203 Česká republika, garant, domácí)

Vydání

PHARMACOLOGY, BASEL, KARGER, 2020, 0031-7012

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30104 Pharmacology and pharmacy

Stát vydavatele

Švýcarsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.547

Kód RIV

RIV/00216224:14110/20:00115304

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1159/000502847

UT WoS

000508853800010

Klíčová slova anglicky

Low molecular weight heparin; Pharmacokinetics; Anti-factor Xa activity; Thromboembolism; Prophylaxis; Vasopressors

Štítky

14110122, 14110212, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 31. 8. 2020 12:12, Mgr. Tereza Miškechová

Anotace

V originále

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.

Citovat

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. PHARMACOLOGY. BASEL: KARGER, 2020, roč. 105, 1-2, s. 73-78. ISSN 0031-7012. Dostupné z: https://dx.doi.org/10.1159/000502847.

@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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