Enoxaparin resistance is proportional to the total body surface area of burn patients and in response to this, in 2020, the National Burn Centre have instituted factor Xa targeted dosing of enoxaparin. This is a review of blood transfusion requirements and thromboembolic events within this cohort compared to standard prophylaxis.
We present a 6 year review of all adult patients with >20%TBSA admitted. 196 patients in total, of which 39 received titrated anti-XA dosing and 155 received standard prophylaxis.
For the enoxaparin titrated to anti Xa levels group, 33 required RBC, the mean number of RBC transfused was 21.1 units (range 2-83). Of the patients who had standard prophylaxis, 55 patients required RBCS, the mean number of RBC units was 19.6 units (range 1-135).
The titrated anti-Xa group there were 2 thromboembolic events both IVJ thrombus associated with line insertion. The standard prophylaxis group reported 7 thromboembolic events including 3 pulmonary embolisms, 2 IVJ line thrombosis, 1 DVT and 1 atrial clot.
The introduction of dosage to anti-Xa levels has resulted in a slight elevation of transfusion requirements and a reduction in thromboembolic events. Further demographics and discussion will be presented.