Evidence map›Paper›PMID 34042098›Full record

Observational studyBiomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia2022

Fixed-dose enoxaparin provides efficient DVT prophylaxis in mixed ICU patients despite low anti-Xa levels: A prospective observational cohort study.

Jan Benes, Roman Skulec, Jakub Jobanek, Vladimir Cerny

Registry-linked trialOpen access · goldAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03286985 (The Prevalence and Incidence of Deep Venous Thrombosis in General ICU Patients Receiving Enoxaparine Prophylaxis), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.7field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03286985 completednot on this map

The Prevalence and Incidence of Deep Venous Thrombosis in General ICU Patients Receiving Enoxaparine Prophylaxis

TypeobservationalSponsorMasaryk Hospital Krajská zdravotní a.s.Ran2017 to 2017Enrolled200ConditionsDeep Venous Thrombosis
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Observational
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 2 countries.

Jan BenesFaculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic.
Roman SkulecFaculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic.
Jakub JobanekDeartment of Anesthesiology, Perioperative Medicine and Intensive Care Masaryk Hospital, J.E. Purkinje University, Usti nad Labem, Czech Republic.
Vladimir CernyDeartment of Anesthesiology, Perioperative Medicine and Intensive Care Masaryk Hospital, J.E. Purkinje University, Usti nad Labem, Czech Republic.
Charles University · CZDalhousie University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDeep vein thrombosis (DVT) is a serious but preventable complication of critical illness with a reported incidence from 4 to 17%. Anti-Xa activity in critically ill patients achieved with standard dosing of low-molecular-weight heparins (LMWH) is often below the target of 0.2-0.5 IU/mL. However, the clinical significance of this finding is unclear. The quality of thromboprophylaxis also strongly impacts the incidence of DVT. We performed a prospective observational study to evaluate the incidence of DVT in a mixed medical-surgical-trauma intensive care unit (ICU) using a thromboprophylaxis protocol with a fixed dose of enoxaparin. We also explored the relation between DVT incidence and anti-Xa activity.

methodAll consecutive patients with expected ICU stay ≥72 hours and without evidence of DVT upon admission were included. They underwent ultrasound screening for DVT twice a week until ICU discharge, death, DVT or pulmonary embolism. Peak anti-Xa activity was measured twice a week. Patients received 40 mg of enoxaparin subcutaneously (60 mg in obese, 20 mg in case of renal failure). Graduated compression stockings were used in case of LMWH or another anticoagulant contraindication.

resultsA total of 219 patients were enrolled. We observed six cases of DVT (incidence of 2.7%). The agreement between expected and delivered DVT prophylaxis was 94%. Mean peak anti-Xa activity level was 0.24 (SD, 0.13) IU/mL. There was no significant difference in anti-Xa activity in DVT and non-DVT group.

conclusionA low incidence of DVT was achieved with meticulous adherence to the standard prophylactic protocol. The low incidence of DVT was observed despite low levels of anti-Xa activity. Our findings suggest that enoxaparin dose adjustment based on regular monitoring of anti-Xa activity is unlikely to result in further reduction of DVT incidence in a mixed ICU population.

trial registrationClinicalTrials.gov, NCT03286985.

Indexed as

EnoxaparinVenous ThromboembolismAnticoagulantsCritical IllnessHeparin, Low-Molecular-WeightHumansIntensive Care UnitsProspective StudiesAnticoagulantsEnoxaparinHeparin, Low-Molecular-Weightanti-Xacompression ultrasound testenoxaparinpulmonary embolismthromboprophylaxis intensive care unitsvenous thrombosis

Identifiers

PMID34042098
OpenAlexW3164345252

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.