Thrombosis

Scientists at Oregon Health & Science University report research in thrombosis

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"Antifactor Xa activity (anti-Xa) has been used to monitor enoxaparin dosing but its accuracy and availability are problematic. Thrombelastography (TEG) is used to evaluate coagulation in diverse settings. The purpose of this study was to analyze whether TEG could be used to predict which enoxaparin-treated patients would develop DVT. Two hundred sixty-one simultaneous enoxaparin-active (active) and enoxaparin-neutratized (neutral) TEGs were performed in 61 surgical ICU patients over four consecutive days. characteristics and anti-Xa were collected. DVT screening was per ICU protocol. Mean (+/- SEM) age was 54 (+/- 2.3) years and Acute Physiology and Chronic Health Evaluation H score was 17 (+/- 0.7). There were 30 trauma and 31 general surgery patients (69% men). The DVT rate was 28%. Time to clot formation ® and percent lysis at 30 minutes were different between active versus neutralized blood (p < 0.001). R time was 1.5 minutes shorter in patients with DVT versus those without (p < 0.001) indicating hypercoagulability in DVT patients. Anti-Xa levels were similar in patients with (0.135 +/- 0.012) and without (0.135 +/- 0.007) DVT (p = 0.97). There were no differences in age, body mass in dex, injury severity score, Acute Physiology and Chronic Health Evaluation H score, or trauma status between DVT and non-DVT groups. TEG demonstrates differences between enoxaparin-neutralized and enoxaparin-active blood in ICU patients that may be used to guide dosing. TEG differentiates enoxaparin-treated patients who subsequently develop DVT while anti-Xa levels do not," wrote P.Y. Van and colleagues, Oregon Health & Science University.

The researchers concluded: "TEG demonstrates an enoxaparin-related increase in fibrinolysis.."

Van and colleagues published their study in the Journal of Trauma - Injury Infection and Critical Care (Thrombelastography Versus AntiFactor Xa Levels in the Assessment of Prophylactic-Dose Enoxaparin in Critically Ill Patients. Journal of Trauma - Injury Infection and Critical Care, 2009;66(6):1509-1517).

For additional information, contact M.A. Schreiber, Oregon Health Sciences University, Division Trauma & Critical Care, Dept. of Surgery, 3181 SW Sam Jackson Pk Rd., Mail Code L611, Portland, OR 97239, USA.

The publisher of the Journal of Trauma - Injury Infection and Critical Care can be contacted at: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

Keywords: United States, Portland, Anticoagulant, Coagulation, Critical Care, Enoxaparin, Fibrinolysis, Fibrinolytic Agent, Heparin, Physiology, Thrombosis, Venous Thrombosis, Oregon Health & Science University.

This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2009, Biotech Business Week via NewsRx.com.