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- W4313218457 abstract "Introduction: There is limited guidance on the appropriate dosing for pharmacological prophylaxis for venous thromboembolism (VTE) in critically ill underweight patients. This study aims to evaluate safety and efficacy of standard-dose subcutaneous heparin compared to dose-reduced subcutaneous heparin for VTE prophylaxis in critically ill underweight patients. Methods: This was a multicenter, retrospective chart review study. Underweight [body mass index (BMI) < 18 kg/m2] adult (≥18 years old) patients were included if they were admitted to the intensive care unit (ICU) for ≥48 hours, on subcutaneous heparin for VTE prophylaxis for >48 hours. Patients were categorized into two cohorts, standard-dose heparin (≥15,000 units/day) cohort and dose-reduced heparin (< 15,000 units/day) cohort. The primary outcome evaluated was new-onset clinically significant bleed; secondary outcomes were new VTE, ICU and hospital length of stay, and in-hospital mortality. Results: Of the 255 patients included, 175 (68.63%) patients received standard-dose heparin and 80 (31.37%) patients received dose-reduced heparin. Overall, the baseline demographics were similar between the two groups, however, there were statistically significant differences in gender and baseline tissue plasminogen activator usage. Median heparin dose (standard vs. dose-reduced) was 319.15 [279.59-347.63] vs. 221.73 [202.33-241.69] units/kg/day. Heparin duration was similar between the two groups (8.63 [5.61-13.67] vs. 7.59 [4.40-12.68] days; p=0.17). There was a statistically significant difference in the incidence of clinically significant bleeding between the standard and dose-reduced heparin groups (9.14% vs. 1.25%; p=0.04). There was no difference in the incidence of VTE (2.29% vs. 1.25%; p=0.95), ICU length of stay (5.00 [3.00-9.86] vs. 4.13 [2.94-7.73] days; p=0.10), hospital length of stay (15.06 [8.78-31.32] vs. 14.64 [8.84-21.34] days; p=0.23) or hospital mortality (9.14% vs. 11.25%; p=0.77). Conclusions: In this cohort, more bleeds were reported with standard-dose heparin compared to the dose-reduced heparin without an increase in new VTE. Dose-reducing heparin in critically ill underweight patients for VTE prophylaxis should be considered. Larger studies are needed to confirm these findings." @default.
- W4313218457 created "2023-01-06" @default.
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- W4313218457 date "2022-12-15" @default.
- W4313218457 modified "2023-09-26" @default.
- W4313218457 title "41: SUBCUTANEOUS HEPARIN DOSE IN UNDERWEIGHT CRITICALLY ILL PATIENTS" @default.
- W4313218457 doi "https://doi.org/10.1097/01.ccm.0000906040.07000.85" @default.
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