Supratherapeutic anti-factor Xa levels in patients receiving prophylactic doses of enoxaparin: A case series. (2016)

• Record Type: Journal Article
• Authors: Pannucci, Christopher J.; Varghese, Thomas K.; Graves, Kencee K.; Prazak, Ann Marie
• Is Part Of: International journal of surgery case reports. Volume 28(2016)
• Page Start: 114
• Page End: 116
• Publication Date: 2016
• Subjects: Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2016.09.034
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Anti-factor Xa level monitoring in patients receiving prophylactic enoxaparin is increasingly common. We report on a series of cancer patients with therapeutic or supratherapeutic anti-Factor Xa levels while on prophylactic doses of enoxaparin after surgical procedures. Elevated anti-Factor Xa levels can result from heparin contamination of anti-Factor Xa specimens removed from central lines or chemoports. Inappropriately drawn anti-Factor Xa levels may contribute to prophylaxis interruption or unnecessary workup for renal or liver failure. Abstract: Introduction: Enoxaparin prophylaxis prevents venous thromboembolism in surgical patients. Real time anti-Factor Xa monitoring for surgical patients on enoxaparin prophylaxis is increasingly common. Presentation of cases: We report on three cancer patients with therapeutic or supratherapeutic anti-Factor Xa levels while on prophylactic doses of enoxaparin after surgical procedures. In all cases, elevated anti-Factor Xa levels were the result of blood specimens being removed from a heparinized chemoport. Discussion: This case series highlights the importance of peripheral venipuncture or appropriate blood wasting from central access sites for anti-Factor Xa levels. Conclusion: Inappropriately drawn anti-Factor Xa levels may contribute to prophylaxis interruption or unnecessary workup for renal or liver failure.