Anticoagulation Monitoring in the Intensive Care Unit

Gilbert, Brian W.; Reeder, Jacob A.; Reynolds, Tessa R.; Tabaka, Caitlynn A; Rech, Megan A.

doi:10.1097/cnq.0000000000000394

Cited by 3 publications

(2 citation statements)

References 58 publications

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“…It is also true that anticoagulants in the ICU are routinely used to prevent and treat clots. For prophylaxis usage, the dosage is lower than the current anticoagulant dosage used in most protocols for COVID-19 patients [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Variants in Critically Ill Patients: A Comparison of the Delta and Omicron Variant Profiles

Corriero

Ribezzi

Mele

et al. 2022

Infectious Disease Reports

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Background: Coronavirus disease is a pandemic that has disrupted many human lives, threatening people’s physical and mental health. Each pandemic wave struck in different ways, infectiveness-wise and mortality-wise. This investigation focuses on critically ill patients affected by the last two variants, Delta and Omicron, and aims to analyse if any difference exists between the two groups. Methods: intensive care unit (ICU) COVID-19 consecutive admissions between 1 October 2021 and 31 March 2022 were recorded daily, and data concerning the patients’ demographics, variants, main comorbidities, ICU parameters on admission, and the outcome were analysed by a univariate procedure and by a multivariate analysis. Results: 65 patients were enrolled, 31 (47.69%) belonging to the Omicron versus 34 (52.31%) to the Delta group. The mortality rate was 52.94% for the Omicron group versus 41.9% for the Delta group. A univariate analysis showed that the Omicron variant was associated with total comorbidities number, Charlson Comorbidity Index (CCI), pre-existing pulmonary disease, vaccination status, and acute kidney injury (AKI). In stepwise multivariate analysis, the total number of comorbidities was positively associated with the Omicron group, while pulmonary embolism was negatively correlated with the Omicron group. Conclusion: Omicron appears to have lost some of the hallmarks of the Delta variant, such as endothelialitis and more limited cellular tropism when it comes to the patients in the ICU. Further studies are encouraged to explore different therapeutic approaches to treat critical patients with COVID-19.

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Section: Discussionmentioning

confidence: 99%

COVID-19 Variants in Critically Ill Patients: A Comparison of the Delta and Omicron Variant Profiles

Corriero

Ribezzi

Mele

et al. 2022

Infectious Disease Reports

View full text Add to dashboard Cite

show abstract

“…These are used for the diagnosis of various hereditary and acquired hemostatic disorders and also to monitor anticoagulant therapy i.e. PT/INR for vitamin K antagonists and APTT for unfractionated heparin [1]. These are also the most requested tests in Emergency Medicine in cases of sepsis and DIC [2].…”

Section: Introductionmentioning

confidence: 99%

Effect of Delayed Preparation of Platelet Poor Plasma on Coagulation Studies at Room Temperature

Younas,

Imtiaz,

Imran

et al. 2023

Pak J Pathol

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Objective: To determine the effect of delay in the preparation of platelet poor plasma (PPP) on prothrombin time (PT) and activated partial thromboplastin time (APTT) at room temperature (RT). Material and Methods: It was a cross sectional study, conducted at Chughtai Institute of Pathology from January 2022 to June 2022. Total 100 healthy individuals, both males and females, participated in the study. Centrifugation of four citrated blood samples was done at 4000 g for 10 minutes at RT; first sample at 0 hour (h), second sample at 4 h, third sample at 8 h and fourth sample at 24 h. PT and APTT were run on each PPP using Sysmex CS-1600.The values at different times were noted and compared through careful statistical analysis of the observed parameters. Results: There was statistically significant difference for PT at 24h storage time when compared with baseline value at 0h (P value 0.0017) but no clinically relevant change up to 24h (<10% percent change). For APTT at RT, statistically significant difference was noted at storage time of 8h (P value 0.0001) and 24h (P value <0.0001) but a clinically relevant change was noted only at 24h (>10% percent change). Conclusion: Blood samples for PT and APTT without centrifugation can be stored for up to 24 hours for PT at RT and for up to 4 hours for APTT at RT. PT and APTT values will not be affected if centrifugation of citrated sample is done within 1 hour of collection and transported at RT in small aliquots. Key Words: Prothrombin time, Activated partial thromboplastin time, Platelet poor plasma, Pre analytical, Centrifugation

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A Review of Thromboelastography for Nurses

Vollmer

Leshko

Wilson

et al. 2023

Critical Care Nurse

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Background Thromboelastography is a viscoelastic test with multiple potential advantages over conventional coagulation tests in various disease states. Thromboelastography rapidly provides qualitative and quantitative information related to a patient’s coagulation status. Objective To describe recent studies of the use of thromboelastography in various clinical states and how thromboelastography is used in coagulation management. Methods A literature review using the MEDLINE and PubMed databases was conducted. The updated methodology for integrated reviews by Whittemore and Knafl was followed. Coauthors evaluated separate areas that were independently reviewed by other coauthors to ensure appropriateness for inclusion. Results The use of thromboelastography for various clinical conditions with challenging hemostatic profiles has increased. This integrative review covers the use of thromboelastography in patients with trauma, medication-induced coagulopathy, acute and chronic liver failure, and cardiothoracic surgery. Potential future directions are also discussed. Discussion Thromboelastography has numerous potential benefits over conventional coagulation tests for assessing coagulation status in patients in various clinical states. Nurses can support clinical decisions to use the most appropriate test for their patients. Conclusions Each team member should be involved in assessing the usefulness of thromboelastography. Critical care nurses and the multidisciplinary team must identify patients in whom its use is warranted, interpret the results, and provide appropriate interventions in response to the results and clinical status of the patient.

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Anticoagulation Monitoring in the Intensive Care Unit

Cited by 3 publications

References 58 publications

COVID-19 Variants in Critically Ill Patients: A Comparison of the Delta and Omicron Variant Profiles

COVID-19 Variants in Critically Ill Patients: A Comparison of the Delta and Omicron Variant Profiles

Effect of Delayed Preparation of Platelet Poor Plasma on Coagulation Studies at Room Temperature

A Review of Thromboelastography for Nurses

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