Direct Oral Anticoagulant Monitoring In The ICU: Clinical Utility And Limitations Of Anti-XA Levels In Unstable Physiology

• Author(s): Nhan Hoang
• Paper ID: 1712947
• Page: 856-866
• Published Date: 30-09-2023
• Published In: Iconic Research And Engineering Journals
• Publisher: IRE Journals
• e-ISSN: 2456-8880
• Volume/Issue: Volume 7 Issue 3 September-2023

Abstract

Direct oral anticoagulants work well in stable patients because they have predictable effects and usually do not need routine tests. In the ICU, the situation is very different. Critical illness changes how the body absorbs and clears medication, and treatments like vasopressors, dialysis, and ECMO can affect drug levels. This makes it hard to know how much anticoagulant effect a patient actually has. Because the usual blood tests do not reflect DOAC activity, many hospitals use anti Xa assays to check whether the drug is still active. These tests can be helpful during emergencies, such as active bleeding, urgent surgery, suspected overdose, or severe kidney failure. They give clinicians a sense of whether DOAC effects are present. However, anti Xa levels are not perfect in the ICU. Organ failure, fluid shifts, inflammation, and various supportive therapies can make the results unreliable. A level may not always match the patient’s true risk of bleeding or clotting, so the test should be used only as a guide and always interpreted alongside the clinical picture. This article explains when anti Xa testing can be useful in the ICU, what its limitations are, and how it can support better decision making in critically ill patients.

Keywords

DOACs, AntiXa, ICU, Criticalillness, Unstablephysiology, Renaldysfunction, Bleedingrisk, Thrombosis, Extracorporeal, Absorption, Anticoagulation

Citations

IRE Journals:
Nhan Hoang "Direct Oral Anticoagulant Monitoring In The ICU: Clinical Utility And Limitations Of Anti-XA Levels In Unstable Physiology" Iconic Research And Engineering Journals Volume 7 Issue 3 2023 Page 856-866

IEEE:
Nhan Hoang "Direct Oral Anticoagulant Monitoring In The ICU: Clinical Utility And Limitations Of Anti-XA Levels In Unstable Physiology" Iconic Research And Engineering Journals, 7(3)