Dose adjusting enoxaparin is necessary to achieve adequate venous thromboembolism prophylaxis in trauma patients

• DOI: 10.1097/ta.0b013e3182788fa7
• Publication Date: 2012-12-27T06:47:56Z
• Authors: Todd W. Costantini; Emily Min; Kevin Box; Vy Tran; Robert D. Winfield; Dale Fortlage; Jay Doucet; Vishal Bansal; Raul Coimbra
• Keywords: Enoxaparin sodium

Standard venous thromboembolism (VTE) prophylaxis with enoxaparin results in inadequate protection certain patients, subtherapeutic plasma anti-Xa levels associated elevated VTE rates. We hypothesized that many trauma patients would be on the standard prophylactic dose of enoxaparin. Our goal was to adjust achieve target take advantage drug based its pharmacologic properties.Patients admitted service were included if they received at least three doses and underwent two screening duplex. Peak 0.2 IU/mL or less considered low, increased by 10 mg twice daily until adequate obtained. A strict duplex protocol followed. Patients excluded diagnosed a deep thrombosis before beginning did not have correctly timed levels.Sixty-one met inclusion criteria. There (4.9%). had mean age 45.9 years predominantly male (70.5%). Of 61 18 (29.5%) therapeutic 30 daily. Compared who daily, 43 (70.5%) more likely male, greater body weight, larger surface area. no significant bleeding events group an adjustment.Most while suggesting prophylaxis. The need for routine use higher effects routinely adjusting rates should study future prospective, randomized trials.Therapeutic study, level IV.