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Fondaparinux dosing in obese patients and surgery: Anticoagulants and Antiplatelets

Buller, MD , Harry R. Methods: Fondaparinux was administered at a once-daily subcutaneous dose of 7.

William Murphy
Tuesday, April 2, 2019
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  • The largest patient included in the study was

  • Half CSO adjusted low molecular weight heparin dose to weight.

  • Phase 2.

  • In comparison, checking an anti-Xa level is reasonably likely to directly affect patient management. Several studies have indeed correlated low trough drug levels with a higher incidence of DVT.

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Article Navigation. Background: Venous thromboembolism VTE is a leading cause of death in obese patients undergoing bariatric surgery BSbut there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population. Latest Issue Alert.

Half CSO adjusted low molecular weight heparin dose to weight. Published by Elsevier Inc. Previous Article Next Article. Article Navigation.

A chart abstraction tool was constructed and personnel at each site were taught how to obtain the desired information. Obese patients, even minor tweaks in the optimal treatment for DVT prophylaxis could improve doskng for tens of thousands of patients. Although it appears that consideration could be made to use higher doses of LMWH to achieve proper therapeutic levels, the true clinical significance of this has yet to be proven. This is attributed to elevated levels of leptin, tissue factor, coagulation factors VII and VIII, thrombin, fibrinogen, von Willebrand factor, plasminogen activator inhibitor 1 that cause hypercoagulability [ 3 ]. Venous thromboembolism is a frequent and potentially serious complication following TKA.

All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic. Email alerts Article Activity Alert. Setting: French obesity specialized care centers CSOwhich are tertiary care referral hospitals for the most severe cases of obesity METHODS: A detailed questionnaire survey 11 opened, 15 closed questions investigating their prophylactic schemes of anticoagulation molecule, dose, weight-adjustment, duration, associated measures, follow-up was sent to the 37 CSO. Background: The MATISSE trials demonstrated that once-daily subcutaneous fondaparinux, a synthetic selective factor Xa inhibitor, was at least as effective and as safe as standard therapies in the initial treatment of deep-vein thrombosis DVT or pulmonary embolism PE. Skip Nav Destination Content Menu. Cited By Web Of Science 2.

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Sign In or Create an Account. Email alerts Article Activity Alert. View Metrics. Published by Elsevier Inc.

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  • Blood 11 :

  • No patient had any bleeding complications.

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  • Oral Sessions November 16, Background: Venous thromboembolism VTE is a leading cause of death in obese patients undergoing bariatric surgery BSbut there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population.

Both drugs are very similar both are oligosaccharides which augment the function of antithrombin-III on factor Xa. Enoxaparin has a half-life of about 4. Warning You have reached the maximum number of saved studies Thromb Haemost 62 3 — Thus, this study concluded that obesity itself, with enoxaparin dosing reduced in some patients, was not a risk factor for worse bleeding or ischemic outcomes following non-ST elevation ACS, and in fact it may be associated with better outcomes. We are the EMCrit Projecta team of independent medical bloggers and podcasters joined together by our common love of cutting-edge care, iconoclastic ramblings, and FOAM. Helpful Tips.

Br J Clin Pharmacol. Supporting Information 1. Am J Surg. Dyslipidemia, hyperglycemia, inflammation, oxidative stress and endothelial dysfunction associated with obesity may also be contributory [ 3 ].

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Latest Issue Alert. Publication types Multicenter Study. Blood ; 11 : Article Navigation.

All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic. Cite Icon Cite. View Large. Oral Sessions November 16, Blood 11 :

Thus in fondaparinux dosing in obese patients and surgery, strongest data seem to support the use of 40 mg of enoxaparin SC every 12 h. Studies which have measured and targeted trough levels were able to achieve trough levels only with a twice-daily dosing regimen. Table 4. Warning You have reached the maximum number of saved studies They also suggested dalteparin and tinzaparin may be dosed once daily, but that enoxaparin may best be dosed twice daily based on a trend toward increased recurrence of VTE with once-daily dosing in one study. In comparison, checking an anti-Xa level is reasonably likely to directly affect patient management.

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There seems to be some convergence in the recent literature that twice-daily, weight-based enoxaparin is probably the best approach. This same assay can also be used to monitor unfractionated heparin therapy based on the same principles. Arch Pathol Lab Med — Chest 2 :eS—eS. BMJ —

In one more non-randomised study on comparison of Enoxaparin 40 mg 12 hourly with 60 mg 12 obese studying levels of anti-Xa levels it was seen surgey mean anti-Xa levels were higher in the 60 mg group but both groups achieved a therapeutic anti-Xa level [ 16 ]. Walenga JM Laboratory monitoring of the clinical effects of low molecular weight heparins. Unfortunately, there remains an absence of RCT-level evidence regarding the optimal dose of enoxaparin in critically ill patients. Bo Cheng.

Detailed Description:. If LMWH is present in the patient plasma, it will bind to antithrombin and form a complex with factor Xa, inhibiting it. A randomized clinical trial. Published : 17 May Most utilize 0. Log In or Register to continue. University HealthSystem Consortium.

Abstract Background: Venous thromboembolism VTE patinets a leading cause of death in obese patients undergoing bariatric surgery BSbut there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population. All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic. Skip Nav Destination Content Menu. Objective: We aimed to evaluate patterns of BS perioperative thromboprophylaxis practices.

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Substances Anticoagulants. All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic. Sign In or Create an Account. Publication types Multicenter Study. Sign In.

N Engl J Med. Chest 2 Suppl :e24S—e43S. Standard prophylactic enoxaparin dosing leads to inadequate anti-Xa levels and increased deep venous thrombosis rates in critically ill trauma and surgical patients. Bariatric surgery carries a mortality rate of 0. It is rather difficult to extrapolate pharmacokinetics to actually relevant clinical measures. Bickford A, Majerick S, Bledsoe J et al Weight-based enoxaparin dosing for venous thromboembolism prophylaxis in the obese trauma patient. So it makes no sense to give the same mg dose to a kg patient and to a kg patient.

  • Anti-Xa activity after enoxaparin prophylaxis in hospitalized patients weighing less than fifty-five kilograms.

  • Blood ; 11 :

  • One study did find a linear correlation between weight and anti-Xa level, suggesting that weight-based dosing might be reasonable in this situation as well figure below.

  • Only 1 center followed systematically anti-Xa activity. Article Navigation.

  • Cited By Web Of Science 2.

Anticoagulants and Antiplatelets. Casey Parker. Drug: Fondaparinux Sodium. Enoxaparin 0. Weight-based enoxaparin dosing and deep vein thrombosis in hospitalized trauma patients: A double-blind, randomized, pilot study.

VolumeIssue Background: The MATISSE trials demonstrated that once-daily subcutaneous fondaparinux, a synthetic selective factor Xa inhibitor, was at least as effective and as safe as standard therapies in the initial treatment of deep-vein thrombosis DVT or pulmonary embolism PE. Previous Article Next Article. Results: The percentage of obese patients was Close Abstract. Close Modal.

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VolumeIssue Sign In. Close Abstract. Background: The MATISSE trials demonstrated that once-daily subcutaneous fondaparinux, a synthetic selective factor Xa inhibitor, was at least as effective and as safe as standard therapies in the initial treatment of deep-vein thrombosis DVT or pulmonary embolism PE. All rights reserved.

Therapeutic dosing of LMWH is weight based, and studies have historically not included dose capping for obese patients. Isr Med Assoc J. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. Contacts and Locations.

You can also search for this author in PubMed Google Scholar. This effect did not disappear when we adjusted for obesity or the time to mobilization. The authors concluded that Fondaparinux was much more likely to produce target prophylactic antifactor Xa levels than enoxaparin. About this article.

Why 40 mg enoxaparin daily isn’t a good dosing strategy

Setting: French obesity specialized care centers CSOwhich are tertiary care referral hospitals for the most severe cases of obesity METHODS: A detailed questionnaire survey 11 opened, 15 closed questions investigating their prophylactic schemes of anticoagulation molecule, dose, weight-adjustment, duration, associated measures, follow-up was sent to the 37 CSO. Article Navigation. Google Scholar.

Blood ; 11 : Substances Anticoagulants. This Site. Oral Sessions November 16, Email alerts Article Activity Alert. Previous Article Next Article.

Half CSO adjusted low molecular weight heparin dose to weight. Results: The percentage of obese patients was Skip Nav Destination Content Menu. Conclusion: Once-daily fondaparinux is at least as effective and as safe as standard therapies in the initial treatment of DVT or PE in obese patients.

Latest Issue Alert. All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic. Fondapsrinux Icon Cite. Background: The MATISSE trials demonstrated that once-daily subcutaneous fondaparinux, a synthetic selective factor Xa obese patients, was at least as effective and as safe as standard therapies in the initial treatment of deep-vein thrombosis DVT or pulmonary embolism PE. Published by Elsevier Inc. Conclusion: This study finds significant discrepancies in thromboprophylaxis practices in obese patients undergoing BS, particularly with respect to treatment duration and dose adjustment, highlighting the urgent need for improved implementation of existing clinical practice guidelines in this VTE high-risk population. Only 1 center followed systematically anti-Xa activity.

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This may be a simple practical option to address patients at extremes of weight. Ann Pharmacother — Rights and permissions Reprints and Permissions.

View Metrics. All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic. Methods: Fondaparinux was administered at a once-daily subcutaneous dose of 7. View Large.

View Large. Article Navigation. Sign In or Create an Account. Background: The MATISSE fondaparinux dosing in obese patients and surgery demonstrated that once-daily subcutaneous fondaparinux, a synthetic selective factor Xa inhibitor, was at least as effective and as safe as standard therapies in the initial treatment of deep-vein thrombosis DVT or pulmonary embolism PE. Substances Anticoagulants. Conclusion: Once-daily fondaparinux is at least as effective and as safe as standard therapies in the initial treatment of DVT or PE in obese patients. VolumeIssue

Conclusion: This study finds significant discrepancies in thromboprophylaxis obese patients in obese patients undergoing BS, particularly with respect to treatment duration and dose adjustment, highlighting the urgent need for improved implementation of existing clinical practice guidelines in this VTE high-risk population. Background: The MATISSE trials demonstrated that once-daily subcutaneous fondaparinux, a synthetic selective factor Xa inhibitor, was at least as effective and as safe as standard therapies in the initial treatment of deep-vein thrombosis DVT or pulmonary embolism PE. All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic. View Metrics. Substances Anticoagulants. VolumeIssue Cite Icon Cite.

Author notes

Blood 11 : Publication types Multicenter Study. VolumeIssue

Blood ; 11 : Previous Article Next Obese patients. Background: Venous thromboembolism VTE is a leading cause of death in obese patients undergoing bariatric surgery Foncaparinuxbut there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population. Abstract Background: Venous thromboembolism VTE is a leading cause of death in obese patients undergoing bariatric surgery BSbut there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population.

Background: Venous thromboembolism VTE is a leading cause of death in obese patients undergoing bariatric surgery BSbut there is neither consensus nor high-level guidelines ;atients on VTE prophylaxis in this specific population. Latest Issue Alert. Conclusion: This study finds significant discrepancies in thromboprophylaxis practices in obese patients undergoing BS, particularly with respect to treatment duration and dose adjustment, highlighting the urgent need for improved implementation of existing clinical practice guidelines in this VTE high-risk population. Author notes Corresponding author. Cite Icon Cite.

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Josh Farkas. Reduced levels of anti-thrombin III are commonly seen enoxaparin works indirectly via enhancement of anti-thrombin III activity, so anti-thrombin III deficiency causes enoxaparin resistance. Article PubMed Google Scholar. A study of enoxaparin 40 mg twice daily compared to 60 mg twice daily achieved average anti-Xa levels of 0. Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Published by Elsevier Inc. Cited By Web Of Science 2. Abstract Background: Venous thromboembolism VTE is a leading cause of death in obese patients undergoing bariatric surgery BSbut there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population. Google Scholar.

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Crit Care. A retrospective cohort study showed that bariatric patients had a mean of 3. Semin Thromb Hemost 37 8 — Arch Pathol Lab Med — Your Job i. Like many agents, most of the anticoagulants were originally studied in populations that included a minimal number of obese patients. Multivariable models were developed using logistic regression.

Weight-based enoxaparin dosing for venous thromboembolism prophylaxis in the obese trauma patient. Also, about half of the patients received only mechanical prophylaxis. In a sensitivity analysis, we did not find any significant changes in the results when the 12 cases that developed VTE on the day of, or day after, TKA were included. Thromb Haemost —

Social Me. Optimal dose of enoxaparin in critically ill trauma and surgical patients. What's Your Job? Therapeutic dosing of LMWH is weight based, and studies have historically not included dose capping for obese patients. Morbidly obese individuals are at high risk for potentially life threatening blood clots around the time of abdominal surgical procedures. Therapeutic LMWH Dosing in VTE —Ina review of literature on LMWH dosing in obesity and renal impairment summarized the data available for both prophylactic and therapeutic dosing, making evidence-based recommendations for clinical practice. Ann Pharmacother.

Thromb Haemost. Numerous studies among critically ill patients have shown that even with weight-based enoxaparin protocols, the peak Xa level is often suboptimal and requires individualized dose adjustment. Helpful Tips. In a secondary sensitivity analysis, the effect of including these early postoperative VTE events on the estimated risk was determined.

Close Abstract. Oral Sessions November 16, Background: Venous thromboembolism VTE is a leading cause of death in obese patients undergoing bariatric surgery BSbut there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population. Publication types Multicenter Study. Half CSO adjusted low molecular weight heparin dose to weight. Blood ; 11 :

Blood ; obese patients : Author notes Corresponding author. Skip Nav Destination Content Menu. All drugs were given for at least 5 days and until surggery with oral anticoagulants was therapeutic. Setting: French obesity specialized care centers CSOwhich are tertiary care referral hospitals for the most severe cases of obesity METHODS: A detailed questionnaire survey 11 opened, 15 closed questions investigating their prophylactic schemes of anticoagulation molecule, dose, weight-adjustment, duration, associated measures, follow-up was sent to the 37 CSO.

J Thromb Thrombolysis 41, — Correspondence to Jeremy W. University Ave.

We take it for granted that patients on a heparin infusion will receive frequent monitoring of anti-Xa level, whereas patients treated with enoxaparin will receive no monitoring. In one retrospective review fondaparinux dosing in obese patients and surgery Enoxaparin 30 mg 12 hourly versus 40 mg 12 hourly, a higher incidence of DVT 5. Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information. Third, this discussion focuses on patients with normal weight or obesity. Inline Feedbacks. This finding was not unexpected and is consistent with other reports in the literature showing a higher incidence of VTE after bilateral TKA compared with unilateral TKA.

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Blood 11 : Abstract Background: Venous thromboembolism VTE is a leading cause of death in obese patients undergoing bariatric surgery BSbut there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population. Cite Icon Cite. Only 1 center followed systematically anti-Xa activity. Close Modal. Sign In.

Contacts and Locations. Bara L, Planes A, Samama MM Occurrence of thrombosis and haemorrhage, relationship with anti-Xa, anti-IIa activities, and d -dimer plasma levels in patients receiving a surgery molecular weight heparin, enoxaparin, or tinzaparin, to prevent deep vein thrombosis after hip surgery. Current Issue. Therapeutic LMWH Dosing in VTE —Ina review of literature on LMWH dosing in obesity and renal impairment summarized the data available for both prophylactic and therapeutic dosing, making evidence-based recommendations for clinical practice. Save this study. Table However, despite the implementation of these standard measures, the reported incidence of fatal PE has ranged from 0.

Teresa-Maria Tomasa-Irriguible. Pharmacologic prophylaxis of deep fondaparnux thrombosis and venous thromboembolism VTE is an important aspect of medical care, particularly in the inpatient setting. Fondaparinux sodium Arixtra is an FDA- approved medication used in the prevention of deep venous thrombosis DVT at the time of orthopedic or abdominal surgery, as well as for the treatment of DVT and pulmonary embolism PE.

  • Comparison of the pharmacokinetic parameters of the 2.

  • Author notes Corresponding author.

  • First, early mobilization with active ambulation in the first 2 days after TKA was strongly associated with lower odds of developing VTE.

  • Am J Surg — Similar to the recent PD studies, the initial and final enoxaparin doses were significantly lower in the morbidly obese population.

No patient received aspirin alone for prophylaxis. This article reviews published data to support specific dosing regimens and monitoring strategies of these agents in this population. Pharmacologic prophylaxis of deep vein thrombosis and venous thromboembolism VTE is an important aspect of medical care, particularly in the inpatient setting. Third, this discussion focuses on patients with normal weight or obesity.

Results: The percentage of obese patients was Methods: Fondaparinux was administered at a once-daily subcutaneous dose of 7. Google Scholar. Cite Icon Cite. Sign In or Create an Account.

Subscription will auto renew annually. An increase in acute-phase reactant proteins may bind enoxaparin, reducing the effective dose. Participants will be monitored closely for any side effects or complications. Published online May 21, Ann Pharmacother —

Cite Icon Cite. All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic. Published by Elsevier Inc. Blood ; 11 :

However, despite the implementation of these standard measures, the reported incidence fondapainux fatal PE has ranged from 0. Fondaparinux dosing in obese patients and surgery LMWH is present in the patient plasma, it will bind to antithrombin and form a complex with factor Xa, inhibiting it. Like many agents, most of the anticoagulants were originally studied in populations that included a minimal number of obese patients. No major adverse events occurred in either arm. This finding emphasizes the importance of early mobilization in prevention of VTE, as has been reported after total hip arthroplasty. Lalama Authors Jeremy W. Participants will be administered two different doses of the medication with a 2-week interval in between, then blood will be drawn in various intervals throughout the next 48 hours to see which dose provides the best therapeutic levels.

Thromb Haemost — Bickford A, Majerick S, Bledsoe J et al Weight-based enoxaparin dosing for venous thromboembolism prophylaxis in the obese trauma patient. Some limitations deserve highlighting.

  • Allman-Farinelli MA Obesity and venous thrombosis: a review.

  • Buller, MDHarry R.

  • Thus, this study concluded that obesity itself, with enoxaparin dosing reduced in some patients, was not a risk factor for worse bleeding or ischemic outcomes following non-ST elevation ACS, and in fact it may be associated with better outcomes. Move Comment.

  • Publication types Multicenter Study. Abstract Background: Venous thromboembolism VTE is a leading cause of death in obese patients undergoing bariatric surgery BSbut there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population.

Cited By Web Of Science 2. Buller, MDHarry R. Results: The percentage of obese patients was Half CSO adjusted low molecular weight heparin dose to weight. Google Scholar. View Metrics.

Particularly among surgical ICU patients, there seems fondaparinux dosing in obese patients and surgery some convergence towards using a weight-based dose of 0. Ann Pharmacother — Studies which have measured and targeted trough levels were able to achieve trough levels only with a twice-daily dosing regimen. Numerous studies among critically ill patients have shown that even with weight-based enoxaparin protocols, the peak Xa level is often suboptimal and requires individualized dose adjustment. Skip to main content. Weight-based enoxaparin dosing for venous thromboembolism prophylaxis in the obese trauma patient. Arch Pathol Lab Med —

Pafients even better -oral agent for prophylaxis What's Your Job? Surg Obes Relat Dis 4 5 — Teresa-Maria Tomasa-Irriguible. All patients received at least 1 type of pharmacologic or mechanical prophylaxis within the first 24 hours after TKA. This implies that 40 mg enoxaparin once daily is wholly inadequate for most above-average weight patients.

Outcomes The principal outcome was validated symptomatic objectively confirmed VTE, manifested as either pulmonary embolism PE or lower extremity deep vein thrombosis DVT or both. Postoperative fondaparinux versus preoperative enoxaparin for prevention of and surgery thromboembolism in elective hip-replacement surgery: a randomised double-blind comparison. This finding was not unexpected and is consistent with other reports in the literature showing a higher incidence of VTE after bilateral TKA compared with unilateral TKA. We take it for granted that patients on a heparin infusion will receive frequent monitoring of anti-Xa level, whereas patients treated with enoxaparin will receive no monitoring. A comparative study of varying doses of enoxaparin for thromboprophylaxis in critically ill patients: a double-blinded, randomised controlled trial. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision.

Fondaparinux dosing in obese patients and surgery This study finds significant discrepancies in thromboprophylaxis practices in obese patients undergoing BS, particularly with respect to treatment duration and dose adjustment, highlighting the urgent obesf for improved implementation of existing clinical practice guidelines in this VTE high-risk population. Substances Anticoagulants. Conclusion: Once-daily fondaparinux is at least as effective and as safe as standard therapies in the initial treatment of DVT or PE in obese patients. Previous Article Next Article. Publication types Multicenter Study. Sign In or Create an Account. All rights reserved.

Vondaparinux Venous thromboembolism VTE is a leading cause of death in obese patients undergoing bariatric surgery BSbut there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population. Oral Sessions November 16, Blood 11 : Objective: We aimed to evaluate patterns of BS perioperative thromboprophylaxis practices.

This finding emphasizes the importance of early mobilization in prevention of VTE, as has been reported after total hip arthroplasty. A retrospective cohort study showed that bariatric patients had a mean of 3. Several studies have indeed correlated low trough drug levels with a higher incidence of DVT.

Simple arithmetic. Pharmacodynamic PD studies suggest that enoxaparin 0. This implies that 40 mg enoxaparin once daily is wholly inadequate for srugery above-average weight patients. Participants will be administered two different doses of the medication with a 2-week interval in between, then blood will be drawn in various intervals throughout the next 48 hours to see which dose provides the best therapeutic levels.

Methods: Fondaparinux was administered suregry a once-daily subcutaneous dose of 7. Background: The MATISSE trials demonstrated that once-daily subcutaneous fondaparinux, a synthetic selective factor Fondaparinux dosing in obese patients and surgery inhibitor, was at least as effective and as safe as standard therapies in the initial treatment of deep-vein thrombosis DVT or pulmonary embolism PE. Oral Sessions November 16, Conclusion: Once-daily fondaparinux is at least as effective and as safe as standard therapies in the initial treatment of DVT or PE in obese patients. Sign In.

We explored the associations between the ln of thromboprophylaxis, obesity, time of mobilization, and undergoing bilateral TKA on development of symptomatic venous thromboembolism VTE after TKA. NOTE: Numbers are mutually exclusive within each column. Low-molecular weight heparins, heparin, and fondaparinux are commonly used agents to prevent VTE, each of which has well established dosing regimens in patients with normal body mass index. Studies which have measured and targeted trough levels were able to achieve trough levels only with a twice-daily dosing regimen.

Methods: Fondaparinux was administered at a once-daily subcutaneous dose of 7. Close Modal. Conclusion: This study finds significant discrepancies in thromboprophylaxis practices in obese patients undergoing BS, particularly with respect to treatment duration and dose adjustment, highlighting the urgent need for improved implementation of existing clinical practice guidelines in this VTE high-risk population. Abstract Background: Venous thromboembolism VTE is a leading cause of death in obese patients undergoing bariatric surgery BSbut there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population.

The dosing strategies for anticoagulants fondapwrinux depend on indication, but both standard and weight-based dosing strategies necessitate additional considerations for obese patients. Study Start Fondaparinux dosing in obese patients and surgery :. One centre administered only 30 mg subcutaneous once preoperatively, one centre administered 30 mg subcutaneous every 24 h post discharge for 10 days, two centres administered 40 mg subcutaneous every 24 h postoperatively and one centre administered 40 mg subcutaneous every 12 h postoperatively. Cushman M Epidemiology and risk factors for venous thrombosis. Administering a suboptimal dose was the most common reason. Ann Pharmacother. Simple arithmetic.

Sign In or Create an Account. VolumeIssue Email alerts Article Activity Alert. Background: The MATISSE trials demonstrated that once-daily subcutaneous fondaparinux, a synthetic selective factor Xa inhibitor, was at least as effective and as safe as standard therapies in the initial treatment of deep-vein thrombosis DVT or pulmonary embolism PE.

VolumeIssue Latest Issue Alert. Buller, MDHarry R. This Site. Email alerts Article Activity Alert.

Sign In or Create an Account. Cite Icon Cite. All rights reserved. Article Navigation. Blood 11 : Email alerts Article Activity Alert. All drugs were given for at least 5 days and until anticoagulation with oral anticoagulants was therapeutic.

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