Correlation between heparin anti‐Xa activity and thromboelastography in adult critically ill COVID‐19 patients
Study Objective Severe coronavirus disease 2019 (COVID‐19) increases the risk of thrombotic complications with unfractionated heparin (UFH) as a commonly used agent in managing venous thromboembolism (VTE). The optimal anticoagulation intensity and monitoring parameters in intensive care unit (ICU)...
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| Veröffentlicht in: | Pharmacotherapy 2023-08, Vol.43 (8), p.795-803 |
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| container_title | Pharmacotherapy |
| container_volume | 43 |
| creator | Buckley, Mitchell S. Benanti, Grace E. Gilbert, Brian Meckel, Jordan Dzierba, Amy L. MacLaren, Robert |
| description | Study Objective
Severe coronavirus disease 2019 (COVID‐19) increases the risk of thrombotic complications with unfractionated heparin (UFH) as a commonly used agent in managing venous thromboembolism (VTE). The optimal anticoagulation intensity and monitoring parameters in intensive care unit (ICU) COVID‐19 patients remains controversial. The primary study aim was to evaluate the relationship between anti‐Xa and thromboelastography (TEG) reaction (R) time in patients with severe COVID‐19 receiving therapeutic UFH infusions.
Design
Single‐center, retrospective study conducted over a 15‐month period (2020–2021).
Setting
Academic medical center (Banner University Medical Center Phoenix).
Patients
Adult patients with severe COVID‐19 administered therapeutic UFH infusions with one or more corresponding TEG, and anti‐Xa assessments drawn within ≤2 hours of each other were included. The primary end point was the correlation between anti‐Xa and TEG R time. Secondary aims were to describe the correlation between activated partial thromboplastin time (aPTT) and TEG R time, as well as clinical outcomes. Pearson's coefficient was used to evaluate the correlation using a kappa measure of agreement. |
| doi_str_mv | 10.1002/phar.2829 |
| format | Article |
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Severe coronavirus disease 2019 (COVID‐19) increases the risk of thrombotic complications with unfractionated heparin (UFH) as a commonly used agent in managing venous thromboembolism (VTE). The optimal anticoagulation intensity and monitoring parameters in intensive care unit (ICU) COVID‐19 patients remains controversial. The primary study aim was to evaluate the relationship between anti‐Xa and thromboelastography (TEG) reaction (R) time in patients with severe COVID‐19 receiving therapeutic UFH infusions.
Design
Single‐center, retrospective study conducted over a 15‐month period (2020–2021).
Setting
Academic medical center (Banner University Medical Center Phoenix).
Patients
Adult patients with severe COVID‐19 administered therapeutic UFH infusions with one or more corresponding TEG, and anti‐Xa assessments drawn within ≤2 hours of each other were included. The primary end point was the correlation between anti‐Xa and TEG R time. Secondary aims were to describe the correlation between activated partial thromboplastin time (aPTT) and TEG R time, as well as clinical outcomes. Pearson's coefficient was used to evaluate the correlation using a kappa measure of agreement.</description><identifier>ISSN: 0277-0008</identifier><identifier>EISSN: 1875-9114</identifier><identifier>DOI: 10.1002/phar.2829</identifier><identifier>PMID: 37199139</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Anticoagulants ; anticoagulation ; Coronaviruses ; COVID-19 ; critical care ; Heparin ; intensive care unit ; Patients ; TEG ; thromboelastography ; Thromboembolism ; Thromboplastin</subject><ispartof>Pharmacotherapy, 2023-08, Vol.43 (8), p.795-803</ispartof><rights>2023 Pharmacotherapy Publications, Inc.</rights><rights>Copyright © 2023 Pharmacotherapy Publications, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3139-d7e30d6409fcc62dcab619a03b80e398555bc0ea1f6b8755c5264061ae6fa7553</cites><orcidid>0000-0002-3385-8105 ; 0000-0002-3569-5506 ; 0000-0002-1527-6830</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fphar.2829$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fphar.2829$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37199139$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Buckley, Mitchell S.</creatorcontrib><creatorcontrib>Benanti, Grace E.</creatorcontrib><creatorcontrib>Gilbert, Brian</creatorcontrib><creatorcontrib>Meckel, Jordan</creatorcontrib><creatorcontrib>Dzierba, Amy L.</creatorcontrib><creatorcontrib>MacLaren, Robert</creatorcontrib><title>Correlation between heparin anti‐Xa activity and thromboelastography in adult critically ill COVID‐19 patients</title><title>Pharmacotherapy</title><addtitle>Pharmacotherapy</addtitle><description>Study Objective
Severe coronavirus disease 2019 (COVID‐19) increases the risk of thrombotic complications with unfractionated heparin (UFH) as a commonly used agent in managing venous thromboembolism (VTE). The optimal anticoagulation intensity and monitoring parameters in intensive care unit (ICU) COVID‐19 patients remains controversial. The primary study aim was to evaluate the relationship between anti‐Xa and thromboelastography (TEG) reaction (R) time in patients with severe COVID‐19 receiving therapeutic UFH infusions.
Design
Single‐center, retrospective study conducted over a 15‐month period (2020–2021).
Setting
Academic medical center (Banner University Medical Center Phoenix).
Patients
Adult patients with severe COVID‐19 administered therapeutic UFH infusions with one or more corresponding TEG, and anti‐Xa assessments drawn within ≤2 hours of each other were included. The primary end point was the correlation between anti‐Xa and TEG R time. Secondary aims were to describe the correlation between activated partial thromboplastin time (aPTT) and TEG R time, as well as clinical outcomes. Pearson's coefficient was used to evaluate the correlation using a kappa measure of agreement.</description><subject>Anticoagulants</subject><subject>anticoagulation</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>critical care</subject><subject>Heparin</subject><subject>intensive care unit</subject><subject>Patients</subject><subject>TEG</subject><subject>thromboelastography</subject><subject>Thromboembolism</subject><subject>Thromboplastin</subject><issn>0277-0008</issn><issn>1875-9114</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp10ctOxCAUBmBiNDpeFr6AIXGji45Ah7YszXhNJtEYNe4aSk8dDFMqUM3sfASf0SeRcdSFiSvCycfPgYPQLiVDSgg76qbSDVnBxAoa0CLniaB0tIoGhOV5QggpNtCm90-R0mzE1tFGmlMhaCoGyI2tc2Bk0LbFFYRXgBZPoZNOt1i2QX-8vT9ILFXQLzrMY6nGYersrLLxlA_20cluOscLXfcmYOV00EoaE2vG4PHV_eVJzKACd_ESaIPfRmuNNB52vtctdHd2eju-SCZX55fj40mi0thaUueQkjobEdEolbFaySqjQpK0KgikouCcV4qApE1WxTdzxVnEGZWQNTLu0y10sMztnH3uwYdypr0CY2QLtvclKyhnI0HyPNL9P_TJ9q6N3UXFM8ZFQURUh0ulnPXeQVN2Ts-km5eUlItBlItBlItBRLv3ndhXM6h_5c_PR3C0BK_awPz_pPL64vjmK_IT-X6VEg</recordid><startdate>202308</startdate><enddate>202308</enddate><creator>Buckley, Mitchell S.</creator><creator>Benanti, Grace E.</creator><creator>Gilbert, Brian</creator><creator>Meckel, Jordan</creator><creator>Dzierba, Amy L.</creator><creator>MacLaren, Robert</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3385-8105</orcidid><orcidid>https://orcid.org/0000-0002-3569-5506</orcidid><orcidid>https://orcid.org/0000-0002-1527-6830</orcidid></search><sort><creationdate>202308</creationdate><title>Correlation between heparin anti‐Xa activity and thromboelastography in adult critically ill COVID‐19 patients</title><author>Buckley, Mitchell S. ; Benanti, Grace E. ; Gilbert, Brian ; Meckel, Jordan ; Dzierba, Amy L. ; MacLaren, Robert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3139-d7e30d6409fcc62dcab619a03b80e398555bc0ea1f6b8755c5264061ae6fa7553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anticoagulants</topic><topic>anticoagulation</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>critical care</topic><topic>Heparin</topic><topic>intensive care unit</topic><topic>Patients</topic><topic>TEG</topic><topic>thromboelastography</topic><topic>Thromboembolism</topic><topic>Thromboplastin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Buckley, Mitchell S.</creatorcontrib><creatorcontrib>Benanti, Grace E.</creatorcontrib><creatorcontrib>Gilbert, Brian</creatorcontrib><creatorcontrib>Meckel, Jordan</creatorcontrib><creatorcontrib>Dzierba, Amy L.</creatorcontrib><creatorcontrib>MacLaren, Robert</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pharmacotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Buckley, Mitchell S.</au><au>Benanti, Grace E.</au><au>Gilbert, Brian</au><au>Meckel, Jordan</au><au>Dzierba, Amy L.</au><au>MacLaren, Robert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Correlation between heparin anti‐Xa activity and thromboelastography in adult critically ill COVID‐19 patients</atitle><jtitle>Pharmacotherapy</jtitle><addtitle>Pharmacotherapy</addtitle><date>2023-08</date><risdate>2023</risdate><volume>43</volume><issue>8</issue><spage>795</spage><epage>803</epage><pages>795-803</pages><issn>0277-0008</issn><eissn>1875-9114</eissn><abstract>Study Objective
Severe coronavirus disease 2019 (COVID‐19) increases the risk of thrombotic complications with unfractionated heparin (UFH) as a commonly used agent in managing venous thromboembolism (VTE). The optimal anticoagulation intensity and monitoring parameters in intensive care unit (ICU) COVID‐19 patients remains controversial. The primary study aim was to evaluate the relationship between anti‐Xa and thromboelastography (TEG) reaction (R) time in patients with severe COVID‐19 receiving therapeutic UFH infusions.
Design
Single‐center, retrospective study conducted over a 15‐month period (2020–2021).
Setting
Academic medical center (Banner University Medical Center Phoenix).
Patients
Adult patients with severe COVID‐19 administered therapeutic UFH infusions with one or more corresponding TEG, and anti‐Xa assessments drawn within ≤2 hours of each other were included. The primary end point was the correlation between anti‐Xa and TEG R time. Secondary aims were to describe the correlation between activated partial thromboplastin time (aPTT) and TEG R time, as well as clinical outcomes. Pearson's coefficient was used to evaluate the correlation using a kappa measure of agreement.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37199139</pmid><doi>10.1002/phar.2829</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-3385-8105</orcidid><orcidid>https://orcid.org/0000-0002-3569-5506</orcidid><orcidid>https://orcid.org/0000-0002-1527-6830</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0277-0008 |
| ispartof | Pharmacotherapy, 2023-08, Vol.43 (8), p.795-803 |
| issn | 0277-0008 1875-9114 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2815249077 |
| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Anticoagulants anticoagulation Coronaviruses COVID-19 critical care Heparin intensive care unit Patients TEG thromboelastography Thromboembolism Thromboplastin |
| title | Correlation between heparin anti‐Xa activity and thromboelastography in adult critically ill COVID‐19 patients |
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