PMID- 31486963
OWN - NLM
STAT- MEDLINE
DCOM- 20201106
LR  - 20201106
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Linking)
VI  - 49
IP  - 2
DP  - 2020 Feb
TI  - Intravenous unfractionated heparin dosing in obese patients using anti-Xa levels.
PG  - 206-213
LID - 10.1007/s11239-019-01942-6 [doi]
AB  - There is limited guidance on intravenous dosing of unfractionated heparin in 
      obese patients. The purpose of this study was to determine the efficacy and 
      safety of a standard unfractionated heparin (UFH) protocol in obese patients 
      based on total body weight (TBW) or adjusted body weight (ABW) to reach two 
      consecutive therapeutic anti-Xa levels. This was a retrospective observational 
      cohort study conducted in a large academic medical center. Adults received a 
      standard UFH protocol between January 1, 2013 to December 31, 2015. Inclusion 
      criteria included age >/= 18 years of age, weight >/= 100 kg with a BMI >/= 30 kg/m(2), 
      and received intravenous UFH. Patients were excluded if they received an 
      alternative UFH protocol, received < 24 h of the standard UFH protocol, or had 
      inadequate compliance to protocol. Out of the 131 patients included, 109 patients 
      reached two consecutive therapeutic UFH levels within 96 h. The average time to 
      two consecutive therapeutic UFH levels was 29.4 h and 27.6 h in patients dosed by 
      TBW and ABW, respectively (95% CI - 4.63 to 8.11; P = 0.93). Safety outcomes 
      included major bleeding, overt bleeding, or death events between patients dosed 
      by TBW compared to ABW, (p = 0.61, p = 1.0, p = 1.0, respectively). Dosing 
      intravenous UFH based on TBW or ABW resulted in similar times to therapeutic 
      anti-Xa levels and safety outcomes. The data provided suggests using either TBW 
      or ABW in obese patients is as effective and safe to use.
FAU - Ebied, Alex M
AU  - Ebied AM
AUID- ORCID: 0000-0003-1133-413X
AD  - Department of Pharmacotherapy and Translational Research, University of Florida 
      College of Pharmacy, Gainesville, FL, USA. ebiedrx55@gmail.com.
FAU - Li, Tammy
AU  - Li T
AD  - Department of Pharmacotherapy and Translational Research, University of Florida 
      College of Pharmacy, Gainesville, FL, USA.
FAU - Axelrod, Samantha F
AU  - Axelrod SF
AD  - Department of Pharmacotherapy and Translational Research, University of Florida 
      College of Pharmacy, Gainesville, FL, USA.
FAU - Tam, Douglas J
AU  - Tam DJ
AD  - Department of Pharmacotherapy and Translational Research, University of Florida 
      College of Pharmacy, Gainesville, FL, USA.
FAU - Chen, Yiqing
AU  - Chen Y
AD  - Data Management Analyst II, University of Florida College of Pharmacy, 
      Gainesville, FL, USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
RN  - 0 (Anticoagulants)
RN  - 0 (Factor Xa Inhibitors)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.21.6 (Factor Xa)
SB  - IM
MH  - Administration, Intravenous
MH  - Adult
MH  - Aged
MH  - Anticoagulants/*administration & dosage
MH  - Cohort Studies
MH  - Dose-Response Relationship, Drug
MH  - Factor Xa/*metabolism
MH  - Factor Xa Inhibitors/*administration & dosage
MH  - Female
MH  - Heparin/*administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity/*blood/*drug therapy
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Anticoagulation
OT  - Drug safety
OT  - Heparin
OT  - Obesity
OT  - Pharmacokinetics
OT  - Therapeutic monitoring
EDAT- 2019/09/06 06:00
MHDA- 2020/11/11 06:00
CRDT- 2019/09/06 06:00
PHST- 2019/09/06 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2019/09/06 06:00 [entrez]
AID - 10.1007/s11239-019-01942-6 [pii]
AID - 10.1007/s11239-019-01942-6 [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2020 Feb;49(2):206-213. doi: 10.1007/s11239-019-01942-6.