How and When to Monitor a Patient Treated with Low Molecular Weight Heparin

Bernard Boneu; Philippe de Moerloose

doi:10.1055/s-2001-17961

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost 2001; 27(5): 519-522
DOI: 10.1055/s-2001-17961

How and When to Monitor a Patient Treated with Low Molecular Weight Heparin

Bernard Boneu¹ , Philippe de Moerloose²

¹Laboratoire d'Hématologie, Hôpital de Rangueil, Toulouse, France
²Laboratoire d'Hémostase, Hôpital Cantonal, Geneva, Switzerland

Abstract

ABSTRACT

Low molecular weight heparins (LMWHs) are as efficient as unfractionated heparin (UFH) for prevention and treatment of thromboembolism. There is no evidence that monitoring the dose improves the clinical efficacy. In contrast, any overdosage increases the risk of hemorrhage. Because renal function plays a significant role in the elimination of LMWH, curative treatment should be monitored with an anti-factor Xa assay in patients presenting renal insufficiency, in the elderly, and in patients presenting an increased hemorrhagic risk. It is advisable to sample the patient at peak activity (3 to 5 hours after the subcutaneous [sc] administration) and to target the mean anti-factor Xa activity that was found efficient and safe in the clinical trial. This target is different for each LMWH and each dose regimen.

KEYWORD

Low molecular weight heparin (LMWH) - thrombosis - pulmonary embolism - renal function - bleeding - prevention - treatment

Full Text

References

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