PMID- 35898262
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230802
IS  - 0018-5787 (Print)
IS  - 1945-1253 (Electronic)
IS  - 0018-5787 (Linking)
VI  - 57
IP  - 4
DP  - 2022 Aug
TI  - Evaluation of Unfractionated Heparin Dosing by Antifactor Xa During Targeted 
      Temperature Management Post Cardiac Arrest.
PG  - 504-509
LID - 10.1177/00185787211061383 [doi]
AB  - PURPOSE: To evaluate unfractionated heparin (UFH) dosing guided by antifactor Xa 
      levels during targeted temperature management (TTM) post-cardiac arrest. METHODS: 
      Single-center, retrospective, observational study between January 1, 2014 and 
      September 1, 2020. Patients initiated on TTM post-cardiac arrest and UFH were 
      evaluated for inclusion. Patients included were >/=18 years of age and received 
      weight-based UFH for >/=6 hours with 2 antifactor Xa levels drawn at target 
      temperature. Excluded patients had no available temperature readings, received 
      extracorporeal membrane oxygenation (ECMO) or factor Xa inhibitor (within 72 
      hours), or had hypertriglyceridemia or hyperbilirubinemia. The primary endpoint 
      was to evaluate the proportion of patients that achieved a therapeutic antifactor 
      Xa level between 0.3 and 0.7 IU/mL at steady state during TTM. Secondary 
      endpoints included average UFH dose and average time to therapeutic antifactor Xa 
      level at steady state; percent of first and total antifactor Xa levels 
      subtherapeutic, therapeutic, and supratherapeutic during TTM. RESULTS: A total of 
      73 patients met inclusion criteria. Of these, 21 patients achieved steady-state 
      therapeutic antifactor Xa levels during TTM. The average time and dose to 
      steady-state therapeutic antifactor Xa levels were 8.1 +/- 4.5 hours and 9.9 +/- 3.2 
      units/kg/hour. Overall, 61.7% of first and 47.4% of all antifactor Xa levels were 
      supratherapeutic during TTM. Three (4.1%) patients experienced a major bleeding 
      event. CONCLUSIONS: Guideline recommended UFH dosing, 12 or 18 units/kg/hour, 
      during TTM resulted in more supratherapeutic antifactor Xa levels. Reduction of 
      UFH infusion dose to 10 units/kg/hour may be required during TTM to maintain 
      therapeutic antifactor Xa levels.
CI  - (c) The Author(s) 2021.
FAU - Belcher, Carrigan
AU  - Belcher C
AUID- ORCID: 0000-0002-5468-5370
AD  - Baylor University Medical Center, Dallas, TX, USA.
FAU - Kataria, Vivek
AU  - Kataria V
AUID- ORCID: 0000-0003-1149-5937
AD  - Baylor University Medical Center, Dallas, TX, USA.
FAU - Ryman, Klayton M
AU  - Ryman KM
AD  - Baylor University Medical Center, Dallas, TX, USA.
FAU - Wang, Xuan
AU  - Wang X
AD  - Baylor Scott & White Health, Dallas, TX, USA.
FAU - Moon, Joon Yong
AU  - Moon JY
AD  - Baylor University Medical Center, Dallas, TX, USA.
FAU - Modrykamien, Ariel
AU  - Modrykamien A
AD  - Baylor University Medical Center, Dallas, TX, USA.
FAU - Mora, Adan
AU  - Mora A
AD  - Baylor University Medical Center, Dallas, TX, USA.
LA  - eng
PT  - Journal Article
DEP - 20211203
PL  - United States
TA  - Hosp Pharm
JT  - Hospital pharmacy
JID - 0043175
PMC - PMC9310313
OTO - NOTNLM
OT  - anticoagulants
OT  - cardiovascular
OT  - critical care
OT  - monitoring drug therapy
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2022/07/29 06:00
MHDA- 2022/07/29 06:01
PMCR- 2023/08/01
CRDT- 2022/07/28 02:04
PHST- 2022/07/28 02:04 [entrez]
PHST- 2022/07/29 06:00 [pubmed]
PHST- 2022/07/29 06:01 [medline]
PHST- 2023/08/01 00:00 [pmc-release]
AID - 10.1177_00185787211061383 [pii]
AID - 10.1177/00185787211061383 [doi]
PST - ppublish
SO  - Hosp Pharm. 2022 Aug;57(4):504-509. doi: 10.1177/00185787211061383. Epub 2021 Dec 
      3.