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Unfractionated heparin infusion for treatment of venous thromboembolism based on actual body weight without dose capping.
- Source :
-
Vascular medicine (London, England) [Vasc Med] 2020 Feb; Vol. 25 (1), pp. 47-54. Date of Electronic Publication: 2019 Oct 18. - Publication Year :
- 2020
-
Abstract
- Controversy exists regarding the use of dose capping of weight-based unfractionated heparin (UFH) infusions in obese and morbidly obese patients. The primary objective of this study was to compare time to first therapeutic activated partial thromboplastin time (aPTT) in hospitalized patients receiving UFH for acute venous thromboembolism (VTE) among three body mass index (BMI) cohorts: non-obese (< 30 kg/m <superscript>2</superscript> ), obese (30-39.9 kg/m <superscript>2</superscript> ), and morbidly obese (⩾ 40 kg/m <superscript>2</superscript> ). In this single-center, retrospective cohort study, patients were included if they ⩾ 18 years of age, had a documented VTE, and were on an infusion of UFH for at least 24 hours. Weight-based UFH doses were calculated using actual body weight. A total of 423 patients met the inclusion criteria, with 230 (54.4%), 146 (34.5%), and 47 (11.1%) patients in the non-obese, obese, and morbidly obese cohorts, respectively. Median times to therapeutic aPTT were 16.4, 16.6, and 17.1 hours in each cohort. Within 24 hours, the cumulative incidence rates for therapeutic aPTT were 70.7% for the non-obese group, 69.9% for the obese group, and 61.7% for the morbidly obese group (obese vs non-obese: HR = 1.02, 95% CI: 0.82-1.26, p = 0.88; morbidly obese vs non-obese: HR = 0.87, 95% CI: 0.62-1.21, p = 0.41). There was no significant difference in major bleeding events between BMI groups (obese vs non-obese, p = 0.91; morbidly obese vs non-obese, p = 0.98). Based on our study, heparin dosing based on actual body weight without a dose cap is safe and effective.
- Subjects :
- Aged
Aged, 80 and over
Anticoagulants adverse effects
Body Mass Index
Drug Monitoring
Female
Hemorrhage chemically induced
Heparin adverse effects
Hospitalization
Humans
Infusions, Parenteral
Male
Middle Aged
Obesity diagnosis
Obesity, Morbid complications
Partial Thromboplastin Time
Retrospective Studies
Venous Thromboembolism blood
Venous Thromboembolism complications
Venous Thromboembolism diagnosis
Anticoagulants administration & dosage
Blood Coagulation drug effects
Body Weight
Drug Dosage Calculations
Heparin administration & dosage
Obesity complications
Venous Thromboembolism drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1477-0377
- Volume :
- 25
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Vascular medicine (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 31623539
- Full Text :
- https://doi.org/10.1177/1358863X19875813