Heparin dosage in obese adults

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To the Editor: We read the article on venous thromboembolism VTE with interest and appreciate that the authors highlight the different treatment options for this disease state. The International Society on Thrombosis and Haemostasis offers some guidance. For patients with a BMI greater than 40 kg per m 2 or weight more than kg, direct oral anticoagulants should not be considered a first-line therapy because of limited clinical data and evidence suggesting decreased exposure, concentration, and half-lives at the weight extremes.

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Electronic address: ehohner1 jhmi. This study aimed to determine optimal weight-based and total therapeutic infusion rates of UFH in this population. METHODS: This retrospective cohort study compared adults on UFH infusions in intensive care units from May through October across 3 weight strata: 95 to kg controlto kg high weightand greater than or equal to kg higher weight.

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Either your web browser doesn't support Javascript or it is currently turned off. In the latter case, please turn on Javascript support in your web browser and reload this page. To evaluate the pharmacokinetic, safety, and effectiveness data of dosing low-molecular-weight heparins LMWHs for prophylaxis of venous thromboembolic events VTEs in obese people.

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Drug doses often warrant adjustment in obese patients. Drug clearance is greater in obesity and correlates with lean body weight. Body size metrics help guide dose selection, but there are advantages and disadvantages to all of them. Few studies have quantified the influence of body size on the pharmacokinetics or pharmacodynamics of many common drugs.

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Dosing weight-based medications in obese patients can often be a tricky proposition. Most medications do not have guidelines for morbidly obesity, forcing clinicians to pursue in-depth literature searches in order to decide on a dose. The purpose of this page is to serve as a dynamic, growing repository of evidence-based recommendations regarding medication dosing in obese patients.

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Available for iPhone or iPad:. Available for Mac and Windows Desktops and laptops:. Heparin AND intravenous dosing of weight based.

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Hohner, R. Kruer, V. Gilmore, Michael B StreiffH.

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Results of a study to determine whether heparin dosing based on adjusted body weight BW Adj instead of actual body weight ABW can lead to faster achievement of therapeutic activated partial thromboplastin time aPTT values in obese patients are presented. A single-center retrospective cohort study was conducted to assess aPTT outcomes before and after implementation of a revised heparin protocol specifying BW Adj -based dosing for obese patients. The primary outcome was the percentage of first aPTT values within the target range after heparin initiation.

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Obesity is endemic in the United States and obese patients are at increased risk of thromboembolism but little data are available for dosing unfractionated heparin UFH. We evaluated the relationship between obesity and UFH efficacy during critical illness by examining UFH infusions in non-obese, obese, and morbidly obese critically ill patients. Retrospective review of UFH infusions in non-obese, obese, and morbidly obese critically ill patients.

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Does high-dose unfractionated heparin safely and effectively prevent venous thromboembolism VTE in overweight and obese patients? This was a single-center retrospective observational cohort study at a large academic medical center. Overweight or obese adult patients admitted to the hospital between January 1,and August 31,who received unfractionated heparin for VTE prophylaxis were included.

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