This feature examines the impact of pharmacologic interventions on the treatment of the critically ill patient — an area of health care that has become increasingly complex. It will review recent advances (including evolving and controversial data) in drug therapy for adult ICU patients and assess these new modalities in terms of clinical, humanistic, and economic outcomes.
SmithB.S., GandhiP.J.Pharmacokinetics and pharmacodynamics of lowmolecular-weight heparins and glycoprotein IIb/IIa receptor antagonists in renal failure.J Thromb Thrombolysis.2001; 11: 39–48.
3.
Alhenc-GelasM., Le GuenicJ., VitouxJ.F.Adjusted versus fixed doses of the low-molecular-weight heparin Fragmin in the treatment of deep vein thrombosis.Thromb Heamost.1994; 71: 698–702.
4.
LaposataM., GreenD., Van CottE.M.College of American Pathologists Conference XXXI on laboratory monitoring of anticoagulant therapy.Arch Pathol Lab Med.1998; 122: 799–807.
5.
BoneuB., de MoerlooseP.How and when to monitor a patient treated with low molecular weight heparin.Sem Thromb Hemost.2001; 27: 519–22.
6.
VittD.E.Personal communication. Pharmion. November 14, 2002.
7.
HeisslerJ.F.Personal communication. Pharmacia. September 25, 2001.
8.
GreavesM.Limitations of the laboratory monitoring of heparin therapy. Scientific and standardization committee communications: On behalf of the control of anticoagulation subcommittee of the scientific and standardization committee of the international society of thrombosis and haemostasis.Thromb Haemost.2002; 87: 163–4.
9.
NaggeJ., CrowtherM., HirshJ.Is impaired renal function a contraindication to the use of low-molecular-weight heparin?Arch Intern Med.2002; 162: 2605–9.
10.
DuplagaB.A., RiversC.W., NutescuE.Dosing and monitoring of low-molecular-weight heparins in special populations.Pharmacotherapy.2001; 21: 218–34.
11.
HuetY., JanviewG., BendrissP.H.Treatment of established venous thromboembolism with enoxaparin: Preliminary report.Acta Chir Scand.1990; 556(suppl); 116–20.
12.
SimonneauG., CharbonnierB., DecoususH.Subcutaneous low-molecular-weight heparin compared with continuous intravenous unfractionated heparin in the initial treatment of proximal deep vein thrombosis.Arch Intern Med.1993; 153: 1541–6.
13.
NieuwenhuisH.K., AlbadaJ., BangaJ.D.Identification of risk factors for bleeding during treatment of acute VTE with heparin or low molecular weight heparin.Blood.1991; 78: 2337–43.
14.
AntmanE.M.Dose-ranging trial of enoxaparin for unstable angina: Results of TIMI 11A.J Am Coll Cardiol.1997; 29: 1474–82.
15.
BeckerR.C., SpencerF.A., GibsonM.Influence of patient characteristics and renal function on factor Xa inhibition pharmacokinetics and pharmacodynamics after enoxaparin administration in non-ST-elevation acute coronary syndromes.Am Heart J.2002; 143: 753–9.
16.
KuijerP., HuttenB., PrinsM.Prediction of the risk of bleeding during anticoagulant treatment for venous thromboembolism.Arch Intern Med.1999; 159: 457–60.
17.
PautasE., GouinI., BellotO.Two hundred very elderly in-patients treated with tinzaparin administered once daily at standard curative dose [abstract]. The XVIIIth Congress of the International Society on Thrombosis and Haemostasis. Paris, France; July 2001.
18.
Dorffler-MellyJ., deJongeE., PontA.C.Bioavailability of subcutaneous low-molecular-weight heparin to patients on vasopressors.Lancet.2002; 359: 849–50.
19.
MayrA.J., DunserM., JochbergerS.Antifactor Xa activity in intensive care patients receiving thromboembolic prophylaxis with standard doses of enoxaparin.Thromb Res.2002; 105: 201–4
20.
CadroyY., PourratJ., BaladreM.F.Delayed elimination of enoxaparin in patients with chronic insufficiency.Thromb Res.1991; 63: 385–90.
21.
GoudableC., SaivinS., HouinG.Pharmacokinetics of low molecular weight heparin (Fraxaparine) in various stages of chronic renal failure.Nephron.1991; 59: 543–5.
22.
BrophyD.F., WaznyL.D., GehrT.W.B.The pharmacokinetics of subcutaneous enoxaparin in end-stage renal disease.Pharmacotherapy.2001; 21: 169–74.
23.
GerlachA.T., PickworthK.K., SethS.K.Enoxaparin and bleeding complications: A review in patients with and without renal insufficiency.Pharmacotherapy.2000; 20: 771–5.
24.
ColletJ.P., MontalescotG., ChoussatR.Enoxaparin in unstable angina patients with renal failure.Int J Cardiol.2001; 80: 81–2.
25.
PolkinghorneK.R., McMahonL.P., BeckerG.J.Pharmacokinetic studies of dalteparin (Fragmin), enoxaparin (Clexane), and danaparoid sodium (Orgaran) in stable chronic hemodialysis patients.Am J Kidney Dis.2002; 40: 990–5.
26.
LeuJ.G., ChiangS.S., LinS.M.Low molecular weight heparin in hemodialysis patients with a bleeding tendency.Nephron.2000; 86; 499–501.
27.
SanderinkG.J., Le LibouxA., JariwalaN.The pharmacokinetics and pharmacodynamics of enoxaparin in obese volunteers.Clin Pharmacol Ther.2002; 72: 308–18.
28.
HainerJ.W., BarrettJ.S., AssaidC.A.Dosing in heavy-weight/obese patients with the LMWH, tinzaparin: A pharmacodynamic study.Thromb Haemost.2002; 87: 817–23.
29.
MerliG., SpiroT.E., OlssonC.G.Subcutaneous enoxaparin once or twice daily compared with intravenous unfractionated heparin for treatment of venous thromboembolic disease.Ann Intern Med.2001; 134: 191–202.
30.
RodieV.A., ThomsonA.J., StewartF.M.Low molecular weight heparin for the treatment of venous thromboembolism in pregnancy: A case series.BJOG.2002; 109: 1020–4.