Excessive XXXX anticoagulation for heparin-induced @entity882 .

@entity1 @entity20806 @entity882
OBJECTIVE: To report 4 @entity1 who became excessively anticoagulated with the recommended or lower starting doses of @entity20806 during treatment for @entity882 ( @entity882 ) in a cardiothoracic intensive care unit. CASE SUMMARY: Four @entity1 were treated with @entity20806 after confirmation of @entity882 after cardiac surgery. In 3 @entity1 , @entity20806 was initiated at the recommended starting dose of 2 micro g/kg/min; in 1 @entity1 , therapy was initiated at 1 micro g/kg/min. All @entity1 had relatively normal hepatic function. In all cases, the resulting activated partial thromboplastin time was supertherapeutic and exceeded 100 seconds in 3 @entity1 . Additionally, @entity20806 clearance appeared to be prolonged upon discontinuation. DISCUSSION: @entity20806 pharmacokinetics in critically ill @entity1 have not been investigated. Our case series demonstrates the potential over-anticoagulation that can occur in this @entity1 population despite relatively normal hepatic function. An objective causality assessment revealed that the adverse drug event in these @entity1 was probably caused by administration of @entity20806 . CONCLUSIONS: Formal pharmacokinetic studies of @entity20806 are needed in critically ill @entity1 in order to optimize therapy.
