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10.1016/j.thromres.2021.07.010 http://scihub22266oqcxt.onion/10.1016/j.thromres.2021.07.010 34311154!8294601!34311154     free     free     free Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Thromb+Res 2021 ; 205 (ä): 120-127 Nephropedia Template TP {{tp|p=34311154|t=2021. Pharmacokinetics of enoxaparin in COVID-19 critically ill patients |pdf=|usr=}}{{34311154}} gab.com Text Pharmacokinetics of enoxaparin in COVID-19 critically ill patients JO: Thromb Res http://www.kidney.de/pget.php?&tw=1&pmid=34311154 #FOAvip BACKGROUND: In intensive-care unit (ICU) patients, pathophysiological changes may affect the pharmacokinetics of enoxaparin and result in underdosing. OBJECTIVES: To develop a pharmacokinetic model of enoxaparin to predict the time-exposure profiles of various thromboprophylactic regimens in COVID-19 ICU-patients. METHODS: This was a retrospective study in ICUs of two French hospitals. Anti-Xa activities from consecutive patients with laboratory-confirmed SARS-CoV-2 infection treated with enoxaparin for the prevention or the treatment of venous thrombosis were used to develop a population pharmacokinetic model using non-linear mixed effects techniques. Monte Carlo simulations were then performed to predict enoxaparin exposure at steady-state after three days of administration. RESULTS: A total of 391 anti-Xa samples were measured in 95 patients. A one-compartment model with first-order kinetics best fitted the data. The covariate analysis showed that enoxaparin clearance (typical value 1.1 L.h-1) was related to renal function estimated by the CKD-EPI formula and volume of distribution (typical value 17.9 L) to actual body weight. Simulation of anti-Xa activities with enoxaparin 40 mg qd indicated that 64% of the patients had peak levels within the range 0.2 to 0.5 IU.mL-1 and 75% had 12-hour levels above 0.1 IU.mL-1. Administration of a total daily dose of at least 60 mg per day improved the probability of target attainment. CONCLUSION: In ICU COVID-19 patients, exposure to enoxaparin is reduced due to an increase in the volume of distribution and clearance. Consequently, enoxaparin 40 mg qd is suboptimal to attain thromboprophylactic anti-Xa levels. Twit Text FOAVip Pharmacokinetics of enoxaparin in COVID-19 critically ill patients ????Thromb Res http://www.kidney.de/pget.php?&tw=1&pmid=34311154 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=34311154 #FOAvip English Wikipedia <ref>{{Cite pmid|34311154}}</ref> Pharmacokinetics of enoxaparin in COVID-19 critically ill patients #MMPMID34311154 Zufferey PJ; Dupont A; Lanoiselee J; Bauters A; Poissy J; Goutay J; Jean L; Caplan M; Levy L; Susen S; Delavenne X Thromb Res 2021[Sep]; 205 (ä): 120-127 PMID34311154show ga BACKGROUND: In intensive-care unit (ICU) patients, pathophysiological changes may affect the pharmacokinetics of enoxaparin and result in underdosing. OBJECTIVES: To develop a pharmacokinetic model of enoxaparin to predict the time-exposure profiles of various thromboprophylactic regimens in COVID-19 ICU-patients. METHODS: This was a retrospective study in ICUs of two French hospitals. Anti-Xa activities from consecutive patients with laboratory-confirmed SARS-CoV-2 infection treated with enoxaparin for the prevention or the treatment of venous thrombosis were used to develop a population pharmacokinetic model using non-linear mixed effects techniques. Monte Carlo simulations were then performed to predict enoxaparin exposure at steady-state after three days of administration. RESULTS: A total of 391 anti-Xa samples were measured in 95 patients. A one-compartment model with first-order kinetics best fitted the data. The covariate analysis showed that enoxaparin clearance (typical value 1.1 L.h-1) was related to renal function estimated by the CKD-EPI formula and volume of distribution (typical value 17.9 L) to actual body weight. Simulation of anti-Xa activities with enoxaparin 40 mg qd indicated that 64% of the patients had peak levels within the range 0.2 to 0.5 IU.mL-1 and 75% had 12-hour levels above 0.1 IU.mL-1. Administration of a total daily dose of at least 60 mg per day improved the probability of target attainment. CONCLUSION: In ICU COVID-19 patients, exposure to enoxaparin is reduced due to an increase in the volume of distribution and clearance. Consequently, enoxaparin 40 mg qd is suboptimal to attain thromboprophylactic anti-Xa levels. |*COVID-19[MESH] |*Enoxaparin/therapeutic use[MESH] |Anticoagulants[MESH] |Critical Illness[MESH] |Humans[MESH] |Retrospective Studies[MESH]Pharmacokinetics of enoxaparin in COVID-19 critically ill patients (epmc).pdf DeepDyve Pubget Overpricing