Comparison of Intravenous Enoxaparin with Subcutaneous Enoxaparin in Preventing Venous Thromboembolism in Patients Admitted to Intensive Care Unit

The use of subcutaneous enoxaparin is a usual method for preventing venous thromboembolism (VTE) in the intensive care unit (ICU) patients, but adequate absorption of the drug is not reliable due to the illness intensity, existing edema and hypoperfusion in these patients. The aim of this study was to compare the effect of intravenous enoxaparin with subcutaneous enoxaparin to prevent VTE in ICU patients.

The current double-blind Randomized clinical trial was performed on 64 patients admitted to the ICU at Khatam- Al- Anbia Hospital in Zahedan, southeast of Iran. The patients were randomly assigned into each of the subcutaneous enoxaparin and the intravenous enoxaparin groups. The blood sampling was performed aseptically and then active factor Xa level was measured. Next, the intervention group received 0.5 mg/kg of intravenous enoxaparin for 10 days and the control group was injected subcutaneously the same dosage of drug. Four hours after the first injection and 12 hours after the last injection on the tenth day, the factor Xa level and the frequency of VTE incidence was measured again.

In all three measurement times, the active factor Xa level in the intravenous enoxaparin group was lower than that of the subcutaneous group, but no significant difference was observed between the two groups and different times (P> 0.05).

The results of this study showed that the use of intravenous enoxaparin is an effective way to prevent the VTE development in the ICU patients.