Diepstraten J, van Kralingen S, Snijder RJ, Hackeng CM, van Ramshorst B, Knibbe CA
Treatment of Pulmonary Embolism in an Extremely Obese Patient. [JOURNAL ARTICLE]
Obes Surg 2009 Jun 9.
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/m(2)) 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/m(2) 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.
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