Changes in coagulation parameters in polytrauma patients with different body mass index according to the enoxaparin-sodium dosing strategy under conventional versus restrictive fluid therapy regimens
Background. Coagulopathy associated with fluid resuscitation and disseminated intravascular coagulation constitutes a devastating complication of polytrauma, leading to the development of multiple organ dysfunction syndrome. Purpose – to conduct a comparative study of the effects of intravenous f...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
V. N. Karazin Kharkiv National University
2025-04-01
|
| Series: | Journal of V. N. Karazin Kharkiv National University: Series Medicine |
| Subjects: | |
| Online Access: | https://ukrmedsci.com/index.php/visnyk/article/view/183 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1839655547316469760 |
|---|---|
| author | М.О. Gogiya S.V. Kursov О.V. Markov O.М. Kudrevych |
| author_facet | М.О. Gogiya S.V. Kursov О.V. Markov O.М. Kudrevych |
| author_sort | М.О. Gogiya |
| collection | DOAJ |
| description | Background. Coagulopathy associated with fluid resuscitation and disseminated intravascular coagulation constitutes a devastating complication of polytrauma, leading to the development of multiple organ dysfunction syndrome.
Purpose – to conduct a comparative study of the effects of intravenous fluid therapy and prophylactic low-molecular-weight heparin therapy in polytrauma patients with varying body mass indices, depending on the method of calculating infusion volume and anticoagulant dosage.
Materials and Methods. A total of 201 patients with polytrauma and closed abdominal injury were enrolled and allocated to six groups. All groups received enoxaparinsodium and infusion therapy according to different protocols. Treatment regimens were selected on the basis of actual body weight, adjusted body weight, or ideal body weight. Coagulation parameters were measured on admission to the operating room, 24 hours after surgery, and on postoperative days 3, 5, 7, and 10.
Results. Our study showed that a fixed fluid infusion of 30 mL/kg based on actual body weight, combined with a «universal» enoxaparin-sodium dose of 40 mg twice daily, produced a moderate yet statistically significant prolongation of prothrombin time (PT) and activated partial thromboplastin time (aPTT) from day 3 to day 10 after injury in polytrauma patients with class I obesity. Switching to adjusted body weight for low-molecular-weight heparin dosing and administering fluids at 40 mL/kg of ideal body weight corrected these coagulation deviations. Reducing the infusion volume to 40 mL/kg of ideal body weight in our sixth group likely lessened hemodilution and normalised PT and aPTT.
Conclusions. The administration of enoxaparin sodium, dosed based on adjusted body weight, in conjunction with a restrictive infusion volume of 40 mL/kg IBW, effectively prevents dilutional coagulopathy and maintains coagulation balance in polytrauma patients with a BMI ≥ 25 kg/m². |
| format | Article |
| id | doaj-art-4e4300c3a5b3447ca3f9ca1c9dea93c6 |
| institution | Matheson Library |
| issn | 2313-6693 2313-2396 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | V. N. Karazin Kharkiv National University |
| record_format | Article |
| series | Journal of V. N. Karazin Kharkiv National University: Series Medicine |
| spelling | doaj-art-4e4300c3a5b3447ca3f9ca1c9dea93c62025-06-25T08:54:53ZengV. N. Karazin Kharkiv National UniversityJournal of V. N. Karazin Kharkiv National University: Series Medicine2313-66932313-23962025-04-01322(53)23524510.26565/2313-6693-2025-53-06Changes in coagulation parameters in polytrauma patients with different body mass index according to the enoxaparin-sodium dosing strategy under conventional versus restrictive fluid therapy regimensМ.О. Gogiya0https://orcid.org/0000-0001-7891-6922S.V. Kursov1https://orcid.org/0000-0003-3539-1489О.V. Markov2https://orcid.org/0009-0009-3306-4098O.М. Kudrevych3https://orcid.org/0000-0002-2086-8822V.N. Karazin Kharkiv National University of the Ministry of Education and Science of Ukraine, Kharkiv, UkraineKharkiv National Medical University of the Ministry of Health of Ukraine, Kharkiv, UkraineV.N. Karazin Kharkiv National University of the Ministry of Education and Science of Ukraine, Kharkiv, UkraineV.N. Karazin Kharkiv National University of the Ministry of Education and Science of Ukraine, Kharkiv, UkraineBackground. Coagulopathy associated with fluid resuscitation and disseminated intravascular coagulation constitutes a devastating complication of polytrauma, leading to the development of multiple organ dysfunction syndrome. Purpose – to conduct a comparative study of the effects of intravenous fluid therapy and prophylactic low-molecular-weight heparin therapy in polytrauma patients with varying body mass indices, depending on the method of calculating infusion volume and anticoagulant dosage. Materials and Methods. A total of 201 patients with polytrauma and closed abdominal injury were enrolled and allocated to six groups. All groups received enoxaparinsodium and infusion therapy according to different protocols. Treatment regimens were selected on the basis of actual body weight, adjusted body weight, or ideal body weight. Coagulation parameters were measured on admission to the operating room, 24 hours after surgery, and on postoperative days 3, 5, 7, and 10. Results. Our study showed that a fixed fluid infusion of 30 mL/kg based on actual body weight, combined with a «universal» enoxaparin-sodium dose of 40 mg twice daily, produced a moderate yet statistically significant prolongation of prothrombin time (PT) and activated partial thromboplastin time (aPTT) from day 3 to day 10 after injury in polytrauma patients with class I obesity. Switching to adjusted body weight for low-molecular-weight heparin dosing and administering fluids at 40 mL/kg of ideal body weight corrected these coagulation deviations. Reducing the infusion volume to 40 mL/kg of ideal body weight in our sixth group likely lessened hemodilution and normalised PT and aPTT. Conclusions. The administration of enoxaparin sodium, dosed based on adjusted body weight, in conjunction with a restrictive infusion volume of 40 mL/kg IBW, effectively prevents dilutional coagulopathy and maintains coagulation balance in polytrauma patients with a BMI ≥ 25 kg/m².https://ukrmedsci.com/index.php/visnyk/article/view/183polytrauma сoagulation profile lowmolecular-weight heparin (lmwh) enoxaparin sodium fluid resuscitation obesity adjusted body weight |
| spellingShingle | М.О. Gogiya S.V. Kursov О.V. Markov O.М. Kudrevych Changes in coagulation parameters in polytrauma patients with different body mass index according to the enoxaparin-sodium dosing strategy under conventional versus restrictive fluid therapy regimens Journal of V. N. Karazin Kharkiv National University: Series Medicine polytrauma сoagulation profile lowmolecular-weight heparin (lmwh) enoxaparin sodium fluid resuscitation obesity adjusted body weight |
| title | Changes in coagulation parameters in polytrauma patients with different body mass index according to the enoxaparin-sodium dosing strategy under conventional versus restrictive fluid therapy regimens |
| title_full | Changes in coagulation parameters in polytrauma patients with different body mass index according to the enoxaparin-sodium dosing strategy under conventional versus restrictive fluid therapy regimens |
| title_fullStr | Changes in coagulation parameters in polytrauma patients with different body mass index according to the enoxaparin-sodium dosing strategy under conventional versus restrictive fluid therapy regimens |
| title_full_unstemmed | Changes in coagulation parameters in polytrauma patients with different body mass index according to the enoxaparin-sodium dosing strategy under conventional versus restrictive fluid therapy regimens |
| title_short | Changes in coagulation parameters in polytrauma patients with different body mass index according to the enoxaparin-sodium dosing strategy under conventional versus restrictive fluid therapy regimens |
| title_sort | changes in coagulation parameters in polytrauma patients with different body mass index according to the enoxaparin sodium dosing strategy under conventional versus restrictive fluid therapy regimens |
| topic | polytrauma сoagulation profile lowmolecular-weight heparin (lmwh) enoxaparin sodium fluid resuscitation obesity adjusted body weight |
| url | https://ukrmedsci.com/index.php/visnyk/article/view/183 |
| work_keys_str_mv | AT mogogiya changesincoagulationparametersinpolytraumapatientswithdifferentbodymassindexaccordingtotheenoxaparinsodiumdosingstrategyunderconventionalversusrestrictivefluidtherapyregimens AT svkursov changesincoagulationparametersinpolytraumapatientswithdifferentbodymassindexaccordingtotheenoxaparinsodiumdosingstrategyunderconventionalversusrestrictivefluidtherapyregimens AT ovmarkov changesincoagulationparametersinpolytraumapatientswithdifferentbodymassindexaccordingtotheenoxaparinsodiumdosingstrategyunderconventionalversusrestrictivefluidtherapyregimens AT omkudrevych changesincoagulationparametersinpolytraumapatientswithdifferentbodymassindexaccordingtotheenoxaparinsodiumdosingstrategyunderconventionalversusrestrictivefluidtherapyregimens |