Anti-Xa Levels in Bariatric Surgery Patients Receiving Prophylactic Enoxaparin

Background Limited data exist regarding efficacy and dosing of low-molecular-weight heparins, including enoxaparin, for morbidly obese patients. Prophylactic doses of 30 to 60 mg every 12 h have been described in bariatric surgery patients with appropriate anti-Xa levels reported between 0.18 and 0....

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Bibliographic Details
Published in:Obesity surgery 2008-02, Vol.18 (2), p.162-166
Main Authors: Rowan, Brea O., Kuhl, David A., Lee, Marilyn D., Tichansky, David S., Madan, Atul K.
Format: Article
Language:English
Subjects:
Adult
Anticoagulants - therapeutic use
Bariatric Surgery
Drug therapy
Enoxaparin - therapeutic use
Factor Xa - analysis
Female
Gastrointestinal surgery
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Morbidity
Obesity
Obesity, Morbid - complications
Research Article
Surgery
Venous Thromboembolism - complications
Venous Thromboembolism - prevention & control
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Summary:Background Limited data exist regarding efficacy and dosing of low-molecular-weight heparins, including enoxaparin, for morbidly obese patients. Prophylactic doses of 30 to 60 mg every 12 h have been described in bariatric surgery patients with appropriate anti-Xa levels reported between 0.18 and 0.6 units/mL. Methods Fifty-two laparoscopic gastric bypass or banding patients were enrolled. Patients were divided into two groups by the dose of enoxaparin that was given: Group 1—enoxaparin 30 mg every 12 hours—and Group 2—enoxaparin 40 mg every 12 h. Anti-Xa levels were obtained 4 h after the first and third doses. Levels between 0.18–0.44 units/mL were considered appropriate. Results There were 19 patients (74% female, mean body mass index [BMI] 48.4 kg/m 2 ) in Group 1 and 33 patients (82% female, mean BMI 48.5 kg/m 2 ) in Group 2. In Group 1, anti-Xa levels were 0.06 and 0.08 units/mL after the first and third doses, respectively. In Group 2, anti-Xa levels were 0.14 and 0.15 units/mL after first and third doses, respectively ( p  = NS). There was a statistically significant difference in anti-Xa levels between Group 1 first dose and Group 2 first dose ( p  
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-007-9381-y