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Preferences for thromboprophylaxis in the intensive care unit: An international survey
ÈRH. Heijkoop, F. Keus, MH. Møller, A. Perner, M. Morgan, A. Abdelhadi, NNM. Al Shirawi, AA. Al-Fares, F. Alshamsi, PP. Ananthan, AS. Andreasen, MH. Anstey, YM. Arabi, TN. Aslam, AG. Attokaran, MH. Bestle, N. Bhadange, AR. Blaser, AC. Brøchner,...
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články
PubMed
40023811
DOI
10.1111/aas.70009
Knihovny.cz E-zdroje
- MeSH
- antikoagulancia * terapeutické užití aplikace a dávkování MeSH
- heparin nízkomolekulární * terapeutické užití aplikace a dávkování MeSH
- internacionalita MeSH
- jednotky intenzivní péče * MeSH
- kritický stav MeSH
- lékaři MeSH
- lidé MeSH
- péče o pacienty v kritickém stavu metody MeSH
- průzkumy a dotazníky MeSH
- žilní tromboembolie * prevence a kontrola MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Venous thromboembolism (VTE) is a frequent complication in critically ill patients, who often have multiple risk factors. Pharmacological thromboprophylaxis is widely applied to lower this risk, but guidelines lack dosing recommendations. OBJECTIVE: This survey aims to assess current thromboprophylaxis preferences and willingness to participate in future randomized clinical trials (RCTs) on this topic. METHOD: We conducted an international online survey between February and May 2023 among intensive care unit (ICU) physicians, including 16 questions about preferences in relation to thromboprophylaxis and preferences on topics for a future RCT. The survey was distributed through the network of the Collaboration for Research in Intensive Care. RESULTS: A total of 715 physicians from 170 ICUs in 23 countries contributed information, with a mean response rate of 36%. In most ICUs, both pharmacological (n = 166, 98%) and mechanical thromboprophylaxis (n = 143, 84%) were applied. A total of 36 pharmacological thromboprophylaxis regimens were reported. Use of low-molecular-weight heparin (LMWH) was most common (n = 149 ICUs, 87%), followed by subcutaneous unfractionated heparin (n = 44 ICUs, 26%). Seventy-five percent of physicians indicated that they used enoxaparin 40 mg (4000 IU), dalteparin 5000 IU, or tinzaparin 4500 IU once daily, whereas 25% reported the use of 16 other LMWH type and dose combinations. Dose adjustment according to weight was common (78 ICUs, 46%). Participants perceived high variation in the application of thromboprophylaxis and were willing to consider an alternative LMWH type (n = 542, 76%) or dose (n = 538, 75%) in the context of an RCT. CONCLUSION: LMWH was the preferred agent for thromboprophylaxis in critically ill patients. There was considerable variation in the application of LMWH for prophylaxis, reflected by the use of different types, doses, and dosing strategies. Most physicians would be willing to participate in an RCT on thromboprophylaxis. EDITORIAL COMMENT: This survey demonstrates current patterns in implementation preferences for critically ill patients. While there is one approach and drug that is commonly preferred, these findings show that there is some variation in practice.
1st Department of Anaesthesiology and Intensive Therapy Medical University of Lublin Lublin Poland
Adult Intensive Care Services The Prince Charles Hospital Brisbane Queensland Australia
Al Qassimi Hospital Emirates Health Service Sharjah United Arab Emirates
College of Health and Medicine Australian National University Canberra Australia
Critical Care Institute Cleveland Clinic Abu Dhabi United Arab Emirates
Critical Care Research University Hospital of Wales Cardiff UK
Department of Anaesthesia and Intensive Care Aalborg University Hospital Aalborg Denmark
Department of Anaesthesia and Intensive Care Lillebaelt Hospital Kolding Denmark
Department of Anaesthesiology and Intensive Care University of Tartu Tartu Estonia
Department of Anaesthesiology Holbaek Hospital Holbaek Denmark
Department of Anaesthesiology Zealand University Hospital Køge Denmark
Department of Anesthesia and Intensive Care IRCCS Humanitas Research Hospital Milan Italy
Department of Anesthesia and Intensive care Södersjukhuset Stockholm Sweden
Department of Biomedical Sciences Humanitas University Milan Italy
Department of Clinical Medicine Aalborg University Aalborg Denmark
Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
Department of Clinical Research University of Basel Basel Switzerland
Department of Clinical science and Education Karolinska Institutet Sweden
Department of Clinical Sciences Karolinska Institutet Danderyd Hospital Stockholm Sweden
Department of Critical Care Bunbury Regional Hospital Bunbury Australia
Department of Critical Care King's College London Guy's and St Thomas' Hospital London UK
Department of Critical Care University of Melbourne Melbourne Victoria Australia
Department of Intensive Care Alfred Health Prahran Victoria Australia
Department of Intensive Care Caboolture Hospital Caboolture Queensland Australia
Department of Intensive Care Copenhagen University Hospital Herlev Herlev Denmark
Department of Intensive Care Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
Department of Intensive Care Dubai Hospital Dubai United Arab Emirates
Department of Intensive Care Gødstrup Regional Hospital Herning Denmark
Department of Intensive Care Jikei University Hospital Tokyo Japan
Department of Intensive Care Nepean Hospital Sydney Australia
Department of Intensive Care Unit Canberra Health Services Canberra Australia
Department of Intensive Care Zealand University Hospital Roskilde Roskilde Denmark
Department of Pulmonary and Critical Care Faculty of Medicine Dokuz Eylu University Izmir Turkiye
Faculty of Medicine The University of Queensland Brisbane Queensland Australia
Faculty of Medicine University of Iceland Reykjavik Iceland
Faculty of Medicine University of Queensland Brisbane Queensland Australia
Fiona Stanley Hospital and University of Western Australia Murdoch Western Australia Australia
Ibrahim bin hamad obaid ullah RAK Ras Al Khaimah United Arab Emirates
Intensive Care Department Lucerne Cantonal Hospital Lucerne Switzerland
Intensive Care Medicine Department of Acute Care University Hospital Basel Basel Switzerland
Intensive Care Services Hawke's Bay Hospital Hastings New Zealand
Intensive Care Unit Al Fujairah Hospital Emirates Health Services Fujairah United Arab Emirates
Intensive Care Unit Ipswich Hospital Ipswich Queensland Australia
Intensive Care Unit Wellington Hospital Wellington New Zealand
Medical Research Institute of New Zealand Wellington New Zealand
Medicine Department University Autonomous of Barcelona Spain
Saqr Hospital EHS Ras Al Khaimah United Arab Emirates
Sir Charles Gairdner Hospital Nedlands Australia
St George Hospital Sydney Australia
University of Queensland Rural Clinical School Rockhampton Queensland Australia
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