Why the study?
The ideal enoxaparin dosing weight metric remains unclear, as actual body weight may increase bleeding risk in obesity while ideal weight may result in underdosing.
Does dosing enoxaparin based on adjusted ideal or lean body weight improve the consistency of factor anti-Xa levels in hospitalized patients compared to actual body weight?
Population
220 in-hospital patients receiving twice-daily enoxaparin for ≥48 h with anti-Xa levels measured
Comparison
Various nominal dosing weight metrics based on IBW, LBW, and actual body weight
Design
Multisite retrospective study
Authors
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IBW +40% or LBW +40% may better align anti-Xa levels in obesity; leaves open need for prospective outcome trials before any practice change.
Does dosing enoxaparin based on adjusted ideal or lean body weight improve the consistency of factor anti-Xa levels in hospitalized patients compared to actual body weight?
In patients with obesity, calculating enoxaparin doses using ideal or lean body weight plus 40% may provide a more consistent factor anti-Xa response than using actual body weight.
Roberts et al. (2024) studied this question.
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