The incidence and mortality of venous thromboembolism(VTE)are high in critically ill patients,and there is still a risk of VTE and bleeding after the use of fixed-dose low molecular weight heparin(LMWH)for prophylaxis.The level of anti-factorⅩa is not up to standard after LMWH prophylaxis in patients with surgery or trauma.The condition of critically ill patients is complicated,and the proportion of patients with low antithrombin Ⅲ is high,which can affect the prophylactic efficacy of LMWH and contribute to VTE occurrence.There is currently no consensus on whether adjusting LMWH dose according to anti-factorⅩa levels can reduce VTE occurrence in critically ill patients.High-quality multicenter randomized controlled studies are needed in the future to establish new approaches for precise prevention of VTE in critically ill patients.
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