[Anticoagulation in critical care]

Anticoagulation is used in intensive care medicine to prevent and treat thromboembolism. The increased risk of bleeding in this patient population requires a personalized approach to management including individualized anticoagulant selection and dose adjustment. While low-molecular-weight heparins are equivalent or superior to unfractionated heparin for thromboprophylaxis, unfractionated heparin is the preferred therapy for the treatment of thromboembolism. Its advantages include a relatively short half-life, the ability to monitor therapy using the activated partial thromboplastin time and the possibility of rapid and effective reversal. The direct thrombin inhibitor argatroban is a reserve anticoagulant used to treat patients with heparin-induced thrombocytopenia. The advantages of argatroban are its short half-life, hepatic clearance, and the ability to monitor therapeutic levels using the activated partial thromboplastin time. Antikoagulanzien werden in der Intensivmedizin zur Thromboseprophylaxe und -therapie eingesetzt. Das meist in diesem Patientenkollektiv erhöhte Blutungsrisiko erfordert eine personalisierte Antikoagulanzienauswahl und -dosierung. Während zur Thromboseprophylaxe niedermolekulare Heparine dem unfraktionierten Heparin gleichwertig oder sogar überlegen sind, ist unfraktioniertes Heparin zur Behandlung von Thromboembolien das bevorzugte Antikoagulans. Vorteile sind die relativ kurze Halbwertszeit, die Möglichkeit der Therapiesteuerung über die aktivierte partielle Thromboplastinzeit und die Möglichkeit der schnellen und effektiven Antagonisierung. Der direkte Thrombininhibitor Argatroban ist ein Reserveantikoagulans, das zur Behandlung von Patienten mit einer heparininduzierten Thrombozytopenie eingesetzt wird. Vorteile von Argatroban sind die kurze Halbwertszeit, die hepatische Elimination und die Möglichkeit der Therapiesteuerung über die aktivierte partielle Thromboplastinzeit.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Anticoagulation is used in intensive care medicine to prevent and treat thromboembolism.

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