Assessment of anti-factor Xa activity of enoxaparin for venous thromboembolism prophylaxis in morbidly obese surgical patients
| Autor: | Maha A. Al Ammari, Zohour Bootah, Shmeylan Al Harbi, Nouf Al Otaib, Salah AbuRuz, Tariq Aldebasi, Abdulmalik M. Alkatheri, Abdulkareem M. Albekairy |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_specialty medicine.drug_class venous thromboembolism Low molecular weight heparin 030204 cardiovascular system & hematology Morbidly obese weight-based dose surgery 03 medical and health sciences 0302 clinical medicine Internal medicine medicine 030212 general & internal medicine Dosing lcsh:RC705-779 obese business.industry Incidence (epidemiology) lcsh:Diseases of the respiratory system Surgery lcsh:RC666-701 Anti-Factor Xa Activity Original Article Cardiology and Cardiovascular Medicine business Body mass index Venous thromboembolism Surgical patients |
| Zdroj: | Annals of Thoracic Medicine Annals of Thoracic Medicine, Vol 12, Iss 3, Pp 199-203 (2017) |
| ISSN: | 1998-3557 1817-1737 |
| Popis: | Background: Venous thromboembolism (VTE) can be encountered by 60% of hospitalized patients. Anticoagulants have been recommended to reduce the risk of VTE in patients with risk factors. However, no specific dosing recommendations for obese patients are provided in the current practice guidelines. The purpose of this study was to determine the efficacy and safety of weight-based dosing of enoxaparin for VTE prophylaxis among morbidly obese patients undergoing surgery. Methods: Adult patients were enrolled if they have a body mass index (BMI) of ≥35 kg/m2 and were scheduled for surgery. These patients were prescribed enoxaparin (0.5 mg/kg subcutaneously [SC] once daily). Peak anti-factor Xa levels were measured 4 h after the third dose of enoxaparin. The primary outcome measure was to determine whether a weight-based dosing of enoxaparin of 0.5 mg/kg produce the anticipated peak anti-Xa levels (0.2–0.6 IU/m) among obese patients undergoing surgery. Secondary outcomes include the incidence of VTE, the incidence of minor or major bleeding, and the incidence of heparin-induced thrombocytopenia (HIT). Results: Fifty patients were enrolled in the study. The mean age was 53 ± 16 years, 74% of the patients were female. The mean BMI was 40.5 ± 5, and the average enoxaparin dose was 50 ± 9.8 SC daily. Nearly 88% of the patients reached the target anti-factor Xa (0.427 ± 0.17). None of the patients developed HIT or VTE. There was no incidence of major or minor bleeding. Conclusions: Weight-based enoxaparin dose led to the anticipated peak anti-Xa levels (0.2–0.6 IU/mL) in most of the morbidly obese study patients undergoing surgery without any evidence of major side effects. The weight-based dosing of enoxaparin was also effective in preventing VTE in all patients. Although these results are promising, further comparative trials are needed in the setting of morbidly obese surgical patients. |
| Databáze: | OpenAIRE |
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