The Use of Average Body Weight in Dosing Unfractionated Heparin

Evaluation of an Unfractionated Heparin Pharmacy Dosing Protocol for the Treatment of Venous Thromboembolism in Nonobese, Obese, and Severely Obese Patients

“…The infusion rate in the obese group to achieve a therapeutic aPTT was found to be 18.2 U/kg/h utilizing DBW, which correlates well with the Raschke nomogram. 9,10 Similar to our study, there was no difference found in bleeding events when using a DBW in obese patients. 19…”

“…8 Subjects included in early trials establishing weight-based heparin dosing for acute VTE had a mean weight of 80 kg, and these studies did not address dosing in the obese patient population. 9,10 More than 2 decades since those studies, the average weight of patients has increased, leaving the question of what weight is the most appropriate to use when dosing heparin for VTE treatment. 11…”

Average-Weight Methodology in Weight-Based Unfractionated Heparin Therapy in the Presence of Obesity

“…This study was approved by the St. Joseph Hospital Institutional Review Board (SJH IRB File 2016-01). The primary outcome was the frequency of an adjusted DLCO value migrating above or below the lower limit of normal (LLN) according to Cotes et al 2 For test data in which the unadjusted and adjusted values were both < LLN, the frequency of a test result changing severity classification was examined. 3 The frequency of an adjusted DLCO changing by > 3 mL/min/mm Hg was also determined.…”

“…We published our limited experience with the use of average-weight methodology in patients with acute coronary syndrome previously. 2 In this brief report, we add to that body of knowledge our experience with patients undergoing catheter ablation for atrial fibrillation (AF).…”

Comprehensive Intraprocedural Unfractionated Heparin Protocol During Catheter Ablation of Atrial Fibrillation in the Presence of Direct Oral Anticoagulants and Wide Spectrum of Body Mass Index

“…We previously validated successful use of the weight-adjusted, weight-based approach to UFH dosing in the presence of obesity in a small number of patients and employed the same approach in the current UFH protocol. 22,23 In this communication, we describe the first comprehensive, weight-adjusted, weight-based UFH protocol in conjunction with various DOACs and report on the efficacy and safety outcomes in patients with a wide spectrum of BMI. The systematic steps in this UFH protocol are guided by incremental ACT measurements and executed by skilled nursing staff, allowing the electrophysiologist to devote his/her attention solely to the performance of the procedure.…”