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.

Basic information

Original name

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

Authors

CIHLÁŘ, Radek (203 Czech Republic, belonging to the institution), Vladimír ŠRÁMEK (203 Czech Republic, belonging to the institution), Adriána PAPIEŽ (703 Slovakia, belonging to the institution), Miroslav PENKA (203 Czech Republic, belonging to the institution) and Pavel SUK (203 Czech Republic, guarantor, belonging to the institution)

Edition

PHARMACOLOGY, BASEL, KARGER, 2020, 0031-7012

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30104 Pharmacology and pharmacy

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 2.547

RIV identification code

RIV/00216224:14110/20:00115304

Organization unit

Faculty of Medicine

DOI

UT WoS

000508853800010

Keywords in English

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

Tags

Tags

International impact, Reviewed
Změněno: 31/8/2020 12:12, Mgr. Tereza Miškechová

Abstract

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.