Anticoagulant properties of enoxaparin 400 IU/mL–40 % ethanol catheter lock solution View Full Text


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Article Info

DATE

2015-12

AUTHORS

Laure Calvet, Michèle Piot, Claire Lartigue, Bertrand Souweine, Brigitte Tardy-Poncet

ABSTRACT

Unfractionated heparin (UFH) is the most widely used interdialytic lock solution but has no anti-infectious properties. Ethanol at a content ≥40 %v/v eradicates experimental biofilm but has no anticoagulant properties. In contrast to UFH, enoxaparin (Enox) can be combined with 40 % ethanol without precipitation. Enoxaparin 400 UI/mL-40 % ethanol (Enox/Eth) has antibiofilm properties and therefore has promise as an alternative lock solution. This study assessed the anticoagulant properties of Enox/Eth. Enox and Enox/Eth were diluted in whole blood at a final Enox concentration of 0.5, 1 (N = 6 samples), 1.5 (N = 4) and 2 (N = 6) IU/mL. Anti-Xa activity was determined by chromogenic assay and the inhibition of endogenous thrombin potential (ETP) by thrombinography. Quantitative data were compared by the Mann-Withney U test. For Enox concentrations of 0.5, 1, 1.5 and 2 UI/mL in whole blood samples, the mean ± SD values of the anti-Xa activity were 0.68 ± 0.09, 1.26 ± 0.14, 1.73 ± 0.30, 2.35 ± 0.32 UI/mL for Enox/Eth and 0.94 ± 0.15, 1.80 ± 0.22, 2.74 ± 0.23, 3.54 ± 0.44 UI/mL for Enox (P = 0.03, P = 0.03, P = 0.13, P = 0.03); and of the percentage of ETP inhibition was 17.36 ± 9.65, 30.27 ± 17.06, 36.5 ± 17.06, 57.82 ± 15.42 for Enox/Eth, and 42.96 ± 15.68, 68.93 ± 10.01, 83.5 ± 8.81, 91.19 ± 4.67 for Enox (P = 0.03, P = 0.03, P = 0.13, P = 0.03), respectively. The median and IQR values of Enox concentration inhibiting 50 % of ETP (IC50 ETP) were 1.8 [1.1-2.4] IU/mL for Enox/Eth and 0.7 [0.3-0.9] IU/mL for Enox, P = 0.03. Enox/Eth has strong anticoagulant activity, albeit lower than that of Enox, but with an extremely low IC50 ETP compared to the Enox concentration of non-diluted Enox/Eth. More... »

PAGES

746

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s40064-015-1533-2

DOI

http://dx.doi.org/10.1186/s40064-015-1533-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1031225954

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26693105


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    "description": "Unfractionated heparin (UFH) is the most widely used interdialytic lock solution but has no anti-infectious properties. Ethanol at a content \u226540\u00a0%v/v eradicates experimental biofilm but has no anticoagulant properties. In contrast to UFH, enoxaparin (Enox) can be combined with 40\u00a0% ethanol without precipitation. Enoxaparin 400\u00a0UI/mL-40\u00a0% ethanol (Enox/Eth) has antibiofilm properties and therefore has promise as an alternative lock solution. This study assessed the anticoagulant properties of Enox/Eth. Enox and Enox/Eth were diluted in whole blood at a final Enox concentration of 0.5, 1 (N\u00a0=\u00a06 samples), 1.5 (N\u00a0=\u00a04) and 2 (N\u00a0=\u00a06) IU/mL. Anti-Xa activity was determined by chromogenic assay and the inhibition of endogenous thrombin potential (ETP) by thrombinography. Quantitative data were compared by the Mann-Withney U test. For Enox concentrations of 0.5, 1, 1.5 and 2\u00a0UI/mL in whole blood samples, the mean\u00a0\u00b1\u00a0SD values of the anti-Xa activity were 0.68\u00a0\u00b1\u00a00.09, 1.26\u00a0\u00b1\u00a00.14, 1.73\u00a0\u00b1\u00a00.30, 2.35\u00a0\u00b1\u00a00.32\u00a0UI/mL for Enox/Eth and 0.94\u00a0\u00b1\u00a00.15, 1.80\u00a0\u00b1\u00a00.22, 2.74\u00a0\u00b1\u00a00.23, 3.54\u00a0\u00b1\u00a00.44\u00a0UI/mL for Enox (P\u00a0=\u00a00.03, P\u00a0=\u00a00.03, P\u00a0=\u00a00.13, P\u00a0=\u00a00.03); and of the percentage of ETP inhibition was 17.36\u00a0\u00b1\u00a09.65, 30.27\u00a0\u00b1\u00a017.06, 36.5\u00a0\u00b1\u00a017.06, 57.82\u00a0\u00b1\u00a015.42 for Enox/Eth, and 42.96\u00a0\u00b1\u00a015.68, 68.93\u00a0\u00b1\u00a010.01, 83.5\u00a0\u00b1\u00a08.81, 91.19\u00a0\u00b1\u00a04.67 for Enox (P\u00a0=\u00a00.03, P\u00a0=\u00a00.03, P\u00a0=\u00a00.13, P\u00a0=\u00a00.03), respectively. The median and IQR values of Enox concentration inhibiting 50\u00a0% of ETP (IC50 ETP) were 1.8 [1.1-2.4] IU/mL for Enox/Eth and 0.7 [0.3-0.9] IU/mL for Enox, P\u00a0=\u00a00.03. Enox/Eth has strong anticoagulant activity, albeit lower than that of Enox, but with an extremely low IC50 ETP compared to the Enox concentration of non-diluted Enox/Eth. ", 
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