Journal Article10.1345/APH.1P088
Identifying optimal initial infusion rates for unfractionated heparin in morbidly obese patients.
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TL;DR: Morbidly obese patients require smaller UFH infusion rates per kilogram actual body weight compared to patients with lower body mass indices, and UFH dosing recommendations should be modified to reflect body mass index classification.
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Abstract: Background:Most literature available for unfractionated heparin (UFH) supports the use of actual body weight for dosing all patients, yet a small proportion of the patients in these studies were morbidly obese. The most appropriate dosing strategy for therapeutic UFH in this patient population is not clearly defined.Objective:To better define appropriate UFH dosing strategies in morbidly obese patients and to evaluate the safety of a weight-based heparin nomogram in this patient population.Methods:Patients with class III (morbid) obesity receiving therapeutic doses of a UFH infusion for greater than 24 hours were evaluated. Two comparator groups of overweight/class I–II obesity and normal/underweight patients were created by matching patients to the class III obesity group. Doses and times to therapeutic activated partial thromboplastin time (aPTT), bleeding rates, and mortality were assessed.Results:The mean infusion rate required to obtain a first therapeutic aPTT was 11.5 units/kg/h in the class III ob...
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Unfractionated heparin dosing for therapeutic anticoagulation in critically ill obese adults
TL;DR: Patients greater than or equal to 130 kg have lower weight-based heparin requirements compared with patients 95 to 104 kg, and this difference appears to be driven by patients greater than 165 kg.
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Evaluation of Weight-Based Dosing of Unfractionated Heparin in Obese Children
TL;DR: In this article, a single-institution retrospective case-matched study included children with and without obesity, matched on a 1:1 basis, who received a weight-based continuous infusion of UFH.
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Comparison of heparin dosing based on actual body weight in non-obese, obese and morbidly obese critically ill patients
Anthony T Gerlach,Jerilynn Folino,Benjamin N. Morris,Claire V. Murphy,Stansilaw P Stawicki,Charles H. Cook +5 more
TL;DR: Dosing of UFH in morbidly obese and obese critically ill patients based on actual body weight and a reduced initial dose was associated with similar time to first therapeutic aPTT and steady state.
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