내과 중환자에서 정맥혈전증의 예방법으로서 Enoxaparin과 Unfractionated heparin의 효과 및 안전성 비교
Enoxaparin versus Unfractionated Heparin for Thromboprophylaxis in Critically Ill patients
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초록
Venous thromboembolism (VTE) significantly contributes to the morbidity and mortality associated with critical illnesses. Because the majority of patients admitted to a critical care unit have multiple risk factors, American College of Chest Physicians recommends using a lowmolecular-weight heparin (LMWH) or unfractionated heparin (UFH) thromboprophylaxis. Theaim of this study was to compare the effect of enoxaparin, a LMWH, to that of UFH on thromboprophylaxis efficacy and safety in critically ill patients. In this retrospective study, we identified patients who received either enoxaparin or UFH for thromboprophylaxis in the medical intensive care unit, during the calendar-year, 2010. We compared the incidence of VTE, thrombocytopenia, bleeding, and death during the hospital stay in the two groups. A total of 38 patients receiving enoxaparin, and 24 patients receiving UFH for thromboprophylaxis were identified. No VTE events were observed in patients receiving UFH, whereas, 2 VTE events were found in patients receiving enoxaparin. There was no significant difference between the groups in the rate of thrombocytopenia, and bleeding. ICU mortality and hospital mortality were similar between the two groups. Among critically ill patients, enoxaparin was not superior to UFH in decreasing the incidence of VTE, thrombocytopenia, bleeding, and mortality.
Abstract
Venous thromboembolism (VTE) significantly contributes to the morbidity and mortality associated with critical illnesses. Because the majority of patients admitted to a critical care unit have multiple risk factors, American College of Chest Physicians recommends using a lowmolecular-weight heparin (LMWH) or unfractionated heparin (UFH) thromboprophylaxis. Theaim of this study was to compare the effect of enoxaparin, a LMWH, to that of UFH on thromboprophylaxis efficacy and safety in critically ill patients. In this retrospective study, we identified patients who received either enoxaparin or UFH for thromboprophylaxis in the medical intensive care unit, during the calendar-year, 2010. We compared the incidence of VTE, thrombocytopenia, bleeding, and death during the hospital stay in the two groups. A total of 38 patients receiving enoxaparin, and 24 patients receiving UFH for thromboprophylaxis were identified. No VTE events were observed in patients receiving UFH, whereas, 2 VTE events were found in patients receiving enoxaparin. There was no significant difference between the groups in the rate of thrombocytopenia, and bleeding. ICU mortality and hospital mortality were similar between the two groups. Among critically ill patients, enoxaparin was not superior to UFH in decreasing the incidence of VTE, thrombocytopenia, bleeding, and mortality.
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