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Obesity Surgery

, Volume 19, Issue 8, pp 1186–1189 | Cite as

Treatment of Pulmonary Embolism in an Extremely Obese Patient

  • Jeroen Diepstraten
  • Simone van Kralingen
  • Repke J. Snijder
  • Christian M. Hackeng
  • Bert van Ramshorst
  • Catherijne A. J. Knibbe
Case Report

Abstract

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/m2) 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/m2 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.

Keywords

Anti-Xa activity Low-molecular-weight heparin Morbid obesity Pulmonary embolism Tinzaparin 

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Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Jeroen Diepstraten
    • 1
  • Simone van Kralingen
    • 2
  • Repke J. Snijder
    • 3
  • Christian M. Hackeng
    • 4
  • Bert van Ramshorst
    • 5
  • Catherijne A. J. Knibbe
    • 1
  1. 1.Department of Clinical PharmacySt. Antonius HospitalNieuwegeinThe Netherlands
  2. 2.Department of AnaesthesiologySt. Antonius HospitalNieuwegeinThe Netherlands
  3. 3.Department of Pulmonary DiseasesSt. Antonius HospitalNieuwegeinThe Netherlands
  4. 4.Department of Clinical ChemistrySt. Antonius HospitalNieuwegeinThe Netherlands
  5. 5.Department of SurgerySt. Antonius HospitalNieuwegeinThe Netherlands

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