A Comparison of Two Different Prophylactic Dose Regimens of Low Molecular Weight Heparin in Bariatric Surgery

  title={A Comparison of Two Different Prophylactic Dose Regimens of Low Molecular Weight Heparin in Bariatric Surgery},
  author={Donald J. Scholten and Rebecca M Hoedema and Sarah E Scholten},
  journal={Obesity Surgery},
Background: Deep venous thrombosis (DVT) is a significant risk in patients undergoing surgery for morbid obesity and may be associated with significant morbidity and mortality. In a consecutive group of patients in one bariatric surgery practice, the initial group of patients who received prophylaxis for DVT was given enoxaparin 30 mg q12h while the later group was given enoxaparin 40 mg q12h. Methods: 481 patients who underwent primary and revisional bariatric surgery over 38 months (October… 

Deep venous thrombosis prevention in bariatric surgery: comparative study of different doses of low weight molecular heparin

There were no statistical differences when higher doses of LWMH were used for prevention of DVT in bariatric surgery patients, in terms of DVt risk, anti-Xa factor levels, or preoperative and postoperative bleeding.

Comparison of two low-molecular-weight heparin dosing regimens for patients undergoing laparoscopic bariatric surgery

Enoxaparin 60-mg every 12 h was superior to a dosage of 40 mg every12 h in achieving therapeutic anti-Xa concentrations and avoiding subtherapeutic anti- Xa levels, and future studies evaluating the relationship of anti-xa concentrationsand outcomes with larger numbers of morbidly obese patients are needed.

Prophylaxis of Venous Thromboembolism with Low Molecular Weight Heparin in Bariatric Surgery: a Prospective, Randomised Pilot Study Evaluating Two Doses of Parnaparin (BAFLUX Study)

A parnaparin dose of 4,250 IU/day seems suitable for VTE prevention in patients undergoing bariatric surgery and the primary safety outcome was major and clinically relevant non-major bleeding.

Review of BMI-Based Pharmacologic Protocols for the Prevention of Venous Thromboembolism in Bariatric Surgery Patients

The objective of this study was to discuss the evolution of three bariatric surgery VTE prophylaxis protocols and compare safety and effectiveness of each, and to recommend three different dosing regimens of enoxaparin.

Anti-Xa Levels in Bariatric Surgery Patients Receiving Prophylactic Enoxaparin

Anti-Xa levels significantly increased with prophylactic dose enoxaparin in bariatric surgery patients, and the percentage of appropriate levels also increased; however, more than half of the patients receiving 40 mg every 12 hours failed to reach therapeutic levels.

Anti-factor Xa levels in patients undergoing laparoscopic sleeve gastrectomy: 2 different dosing regimens of enoxaparin.

  • Shaul GelikasS. EldarG. Lahat
  • Medicine
    Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
  • 2017

Post Discharge Prophylactic Anticoagulation in Gastric Bypass Patient—How Safe?

The use of low molecular weight heparin for prophylactic anticoagulation after open gastric bypass is not associated with risk of major bleeding.

Implementation of an Enoxaparin Protocol for Venous Thromboembolism Prophylaxis in Obese Surgical Intensive Care Unit Patients

Weight-based dosing with enoxaparin in morbidly obese SICU patients was effective in achieving anti-factor Xa levels within the appropriate prophylactic range, and reduced the rate of VTE below expected levels.

Are We Missing Treatment Standards for Thromboprophylaxis of the Obese and Super-Obese Patient Population? A Prospective Systematic Cohort Study

Measurement of the aFXa level helps to define the real prophylactic thromboprophylaxis status in patients with obesity, especially in those with a weight above 150 kg.



Low molecular weight heparins: current use and indications.

A meta-analysis comparing low-molecular-weight heparins with unfractionated heparin in the treatment of venous thromboembolism: examining some unanswered questions regarding location of treatment, product type, and dosing frequency.

Low-molecular-weight heparins are at least as effective as UFH in preventing recurrent VTE and it is unlikely that LMWHs are superior in the treatment of VTE, but they do show a statistically significant decrease in total mortality.

Current Practices in the Prophylaxis of Venous Thromboembolism in Bariatric Surgery

The prevailing opinion of members of the American Society for Bariatric Surgery is that morbidly obese patients are at high risk for developing perioperative venous thromboembolism, and a vast majority routinely use prophylaxis.

The risk assessment profile score identifies trauma patients at risk for deep vein thrombosis.

The RAP score correctly identified trauma patients at increased risk for the development of DVT, and withholding prophylaxis in low-risk patients can reduce hospital charges without risk.

A Guide to Venous Thromboembolism Risk Factor Assessment

Wide practice variations in the prevention of VTE are reported, including an under-utilization of prophylaxis and a lack of awareness among physicians of Vte as a problem.

Heparin: mechanism of action, pharmacokinetics, dosing considerations, monitoring, efficacy, and safety.

The mechanism of action of heparin, its pharmacokinetics, anticoagulant effects, and labo- ratory monitoring will be reviewed and the potential of a new class ofheparins, the low molecular weight heparins (LMWHs) will be discussed and their biophysical, pharmacokinetic, antithrombotic, and hemorrhagic properties will be compared with stan- dard hepar in.

A Decade of Change in Obesity Surgery

Examining changes in the practice of surgical treatment of severe obesity that occurred during the decade of 1986 through 1995 indicates the need for earlier use of operative treatment before irreversible complications of obesity can develop and underscores theneed for standardized long-term data and analyses regarding both weight control and postoperative side-effects.

Death from pulmonary thromboembolism in severe obesity: lack of association with established genetic and clinical risk factors

Morbid obesity is an independent risk factor in cases of sudden death from APT after the exclusion of previously established clinical, environmental, and molecular risk factors.

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The influence of several diseases and conditions upon the prevalence of pulmonary embolism in autopsies performed during a ten year period at the University of Michigan has been analyzed. The major

Prevention of venous thromboembolism.

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