Treatment of Pulmonary Embolism in an Extremely Obese Patient

被引：0
作者：
Jeroen Diepstraten
Simone van Kralingen
Repke J. Snijder
Christian M. Hackeng
Bert van Ramshorst
Catherijne A. J. Knibbe
机构：
[1] St. Antonius Hospital,Department of Clinical Pharmacy
[2] St. Antonius Hospital,Department of Anaesthesiology
[3] St. Antonius Hospital,Department of Pulmonary Diseases
[4] St. Antonius Hospital,Department of Clinical Chemistry
[5] St. Antonius Hospital,Department of Surgery
来源：
Obesity Surgery | 2009年 / 19卷
关键词：
Anti-Xa activity; Low-molecular-weight heparin; Morbid obesity; Pulmonary embolism; Tinzaparin;
D O I：
暂无
中图分类号：
学科分类号：
摘要：
Low-molecular-weight heparins are effective as initial therapy for pulmonary embolism (PE) in a weight-based dosing regimen up to known body weights of 160 kg. The present case reports an extremely obese man of 252 kg (body mass index (BMI) 74 kg/m2) with PE who was treated with tinzaparin, dosed on a body weight of 160 kg. Morbid obesity defined as a BMI higher than 40 kg/m2 is becoming more common in general practice, but there are no evidence-based drug dosing strategies for these patients. This case demonstrates the successful use of a maximum dose of 28,000 anti-Xa international units of tinzaparin for an extremely obese patient with proven PE, instead of the accepted doses of 175 IU/kg, as bridge therapy to a coumarin.
引用
收藏
页码：1186 / 1189
页数：3
相关论文
共 60 条
[1]  
Eikelboom JW(2009)American Association of Orthopedic Surgeons and American College Of Chest Physicians guidelines for venous thromboembolism prevention in hip and knee arthroplasty differ: what are the implications for clinicians and patients? Chest 135 513-520
[2]  
Karthikeyan G(2002)Dosing in heavy-weight/obese patients with the LMWH, tinzaparin: a pharmacodynamic study Thromb Haemost 87 817-823
[3]  
Fagel N(2001)Population pharmacodynamics in patients receiving tinzaparin for the prevention and treatment of deep vein thrombosis Int J Clin Pharmacol Ther 39 431-446
[4]  
Hainer JW(1992)Subcutaneous low-molecular-weight heparin compared with continuous intravenous heparin in the treatment of proximal-vein thrombosis N Engl J Med 326 975-982
[5]  
Barrett JS(2004)Anti-Xa activity relates to survival and efficacy in unselected acute coronary syndrome patients treated with enoxaparin Circulation 110 392-398
[6]  
Assaid CA(2004)Heparin and low-molecular-weight heparin: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy Chest 126 188S-203S
[7]  
Barrett JS(2000)Obesity as a medical problem Nature 404 635-643
[8]  
Gibiansky E(2006)Prevalence of overweight and obesity in the United States, 1999–2004 JAMA 295 1549-1555
[9]  
Hull RD(2003)Pulmonary embolism mortality in the United States, 1979–1998: an analysis using multiple-cause mortality data Arch Intern Med 163 1711-1717
[10]  
Hull RD(1997)A prospective study of risk factors for pulmonary embolism in women JAMA 277 642-645
123456