Revista nº 810

Fábregas-Ruano et al. Anticoagulación en pacientes sépticos · 113 · Actualidad Médica · Número 810 · Mayo/Agosto 2020 Páginas 108 a 113 • La tromboprofilaxis se debe adaptar al perfil de cada paciente. Los autores de la bibliografía consultada coinciden en aconsejar el empleo de HBPM frente a otras medidas profilácticas tanto por posología como por vía de administración y su perfil de seguridad. • Existe controversia sobre el uso de tromboprofi- laxis mecánica, con grado de evidencia 2C. En si- tuaciones de alto riesgo de trombosis y sangrado o de sangrado mayor se sugiere su uso antes que no realizar profilaxis • La realización de niveles de anti-Xa es controvertida. Esta medida farmacodinámica no es representativa de las propiedades antitrombóticas de la HBPM es- tudiada. Las heparinas poseen otros efectos al impli- carse en la función plaquetaria y el mecanismo de inhibición de liberación de factor tisular. Tampoco es representativa del riesgo de sangrado del paciente. 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