Abstract | BACKGROUND: METHODS: Based on a mathematical model, a dosing scheme for danaparoid was designed, aiming at anti-Xa levels of 0.5 to 0.7 U/mL, with a maximum of 1.0 U/mL. This dosing scheme was prospectively tested in the first CVVH run of a cohort of five patients with suspected HIT. CVVH with a blood flow rate of 150 mL/minute and a substitution rate of 2,000 mL/hour was performed with a cellulose triacetate membrane. Danaparoid was administered as a continuous infusion of 100 anti-Xa-U/hour after a loading dose of 3,500 anti-Xa-U. Serial measurements of anti-Xa activity and prothrombin fragment F1+2 were performed at baseline, at t = 5, 15, and 30 minutes, and at t = 1, 2, 4, 8, 16, and 24 hours after the danaparoid loading dose. RESULTS: The median anti-Xa activity reached a maximum of 1.02 (0.66 to 1.31) anti-Xa-U/mL after 15 minutes and gradually declined to 0.40 (0.15 to 0.58) anti-Xa-U/mL over the span of 24 hours. Target anti-Xa levels were reached from 2 to 12 hours after the loading dose. Median prothrombin fragment F1+2 gradually decreased from 432 (200 to 768) to 262 (248 to 317) pmol/L after 24 hours. No bleeding or thromboembolic events occurred throughout the described treatment period. CONCLUSION:
Danaparoid administered by a continuous infusion of 100 anti-Xa-U/hour after a loading dose of 3,500 anti-Xa-U elicited target anti-Xa levels from 2 to 12 hours after the loading dose, without bleeding or thromboembolic events during the described CVVH treatment in patients with suspected HIT.
|
Authors | Anne-Cornélie J M de Pont, Jorrit-Jan H Hofstra, Derk R Pik, Joost C M Meijers, Marcus J Schultz |
Journal | Critical care (London, England)
(Crit Care)
Vol. 11
Issue 5
Pg. R102
( 2007)
ISSN: 1466-609X [Electronic] England |
PMID | 17854496
(Publication Type: Journal Article)
|
Chemical References |
- Anticoagulants
- Dermatan Sulfate
- Chondroitin Sulfates
- Heparitin Sulfate
- danaparoid
|
Topics |
- Aged
- Anticoagulants
(pharmacology)
- Chondroitin Sulfates
(pharmacology)
- Cohort Studies
- Dermatan Sulfate
(pharmacology)
- Dose-Response Relationship, Drug
- Female
- Hemofiltration
(methods)
- Heparitin Sulfate
(pharmacology)
- Humans
- Infusions, Intravenous
- Male
- Pilot Projects
- Prospective Studies
- Thrombocytopenia
(therapy)
- Treatment Outcome
|