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Old 04-15-2020, 06:43 PM   #21300
'Hamas' Jenkins 'Hamas' Jenkins is offline
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Quote:
Originally Posted by dirk digler View Post
Talked to my daughter tonight and she said they are now starting to give Heparin when they put covid patients in ICU
Quote:
Originally Posted by TLO View Post
Blood thinner?
This could be for a lot of reasons.

When patients are in the hospital they are at an increased risk of a clot because most are confined to the bed, which affects venous return. Blood pooling leads to an increased chance of clot formation. Active infection also increases that risk. There is a score called the Padua prediction score that is used to determine if someone needs anticoagulation. Additionally, when patients have sepsis they are at risk of a condition called DIC, where small clots form all over.

Usually a provider will use a low molecular weight heparin (Lovenox is the most common one) to provide prophylaxis because you don't have to dose it as frequently and the risk of a particular side effect is lower. However, in patients that are older or with worsening kidney function, heparin is often used.

If the patients are septic, their renal function will tank because their kidneys aren't getting perfused with blood (BP drops--no pressure, no flow), so the use of heparin in this case makes sense.

At the same time (and this is what makes managing these cases tough), such patients are also at an increased chance of a bleed. Fortunately, heparin has a cheap, plentiful antidote.
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