• Meera V Aggarwal, Andrew S Jarrell, Vi T Gilmore, Jonathan K Aboagye, Elliott R Haut, Deborah B Hobson, Brandyn D Lau, Thomas Kickler, Peggy S Kraus, Dauryne L Shaffer, Kenneth M Shermock, Michael B Streiff, Gang Zheng, and Rachel M Kruer.
• Department of Pharmacy, The Johns Hopkins Hospital, USA.
• J Crit Care. 2019 Aug 1; 52: 180-185.

PurposeThis study compared anti-Xa activity in critically ill patients receiving UFH for VTE prophylaxis between two weight groups (<100 kg vs ≥100 kg).MethodsThis prospective, observational study included critically ill patients on UFH 5000 or 7500 units every 8 h. A peak and trough anti-Xa activity assay was ordered for each patient at steady state. Goal peak anti-Xa activity was 0.1-0.3 units/mL.ResultsFrom March 2017 to June 2018, 75 patients were enrolled with 44 in the <100 kg group and 31 in the ≥100 kg group. There was no significant difference in the percentage of patients with peak anti-Xa activity within goal range between patients <100 kg and ≥ 100 kg (55.3% vs 35.7%, p = 0.12). The odds ratio for achieving peak anti-Xa activity within goal range as weight-based dose increased was 1.03 (95% CI 0.99-1.07). No differences were found in trough anti-Xa activity, VTE, bleeding, length of stay, or death.ConclusionsThough only one-third of patients ≥100 kg had peak anti-Xa activity within goal range, no significant difference was found between the weight groups. Additional prospective studies with adequate sample sizes are warranted to further investigate appropriate weight-based dosing of UFH in critically ill patients.Copyright © 2019 Elsevier Inc. All rights reserved.

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