High-dose anticoagulant trials in ICU patients have been discontinued

Primary High-Dose Anticoagulant Study in Severely Hospitalized Covid-19 Patients Paused The trial leader announced on Tuesday as the treatment seems to be of no benefit and may be of some harm.

An independent oversight committee that demanded a suspension of the trial did not announce the harm it might have found. High doses of anticoagulants are known to cause uncontrolled bleeding in very dangerous areas, such as inside the skull.

Study leaders urgently inform that the study has been suspended, as some hospitals are aggressively administering high doses of anticoagulants to intensive care patients, believing that the benefits outweigh the risks. I’m trying to spread it to, but the opposite may be true.

“We need to publicize the suspension of this trial because it can be harmful,” said a surgeon and intensive care specialist at the University of Pittsburgh Medical Center.

A team of trials enrolling approximately 3,000 patients in some countries will scrutinize the data to see if they can resume enrollment in a branch of trials focused on critically ill inpatients.

Covid-19 is widely known to block capillaries and cause clusters of small blood clots that can damage the lungs, kidneys, heart, brain and other organs, as well as fingers and toes. According to Dr. Neil, hospitalized Covid-19 patients are regularly given low doses of anticoagulants as soon as they are hospitalized.

The department of trials that administer high doses of anticoagulants to patients with moderate illness will continue.

Patients with moderate illness generally include those who are receiving oxygen but are not in the intensive care unit, who are not on a ventilator, or who are at risk of damage to other organs such as the kidneys. included.

During October Observational study The Journal of the American College of Cardiology found that hospitalized Covid-19 patients who received anticoagulants were far superior to those who received nothing. In that study, there was little difference in results or negative side effects between people who received low or high doses.

Dr. Jeffrey S. Berger, director of the Cardiovascular Prevention Center, said, thanks in part to the study, many doctors are most ill when the amount of anticoagulant is suitable for most patients. Another Principal Investigator of the New York University School of Medicine Illness and Suspended Trial thought that the dose should be taken.

“Hopefully this will be humble,” Dr. Berger said of new evidence that high doses may be harmful. “It helps us understand that we don’t have all the answers.”

Anticoagulants are known to cause bleeding under the skin and into the gastrointestinal tract, and wounds that do not heal when punctured in the skin.

Bleeding in the skull is rare, but can cause permanent brain damage or death, Dr. Berger said.

Dr. Neil said he treated Covid’s victims “with problems from both ends of the spectrum of patients with blood clots and patients with bleeding.”

According to Dr. Neil, one of the goals of this study was to figure out which patients were most likely to benefit from anticoagulants.

Patients are often examined D-dimer, Thrombus breakdown products, and C-reactive protein, A marker of inflammation that may be associated with coagulation. Dr. Neil said it would be useful to know if these tests could accurately predict which patients would be most helped by high-dose anticoagulants.

Suspended trials are a large, collaborative effort by what was once three separate clinical trial groups in some countries. It is jointly funded by the National Institutes of Health and the corresponding agencies of Canada, the United Kingdom, Australia and the European Union.

“This is the most collaborative thing I’ve ever done in medicine,” said Dr. Neil.

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