Review of BMI-Based Pharmacologic Protocols for the Prevention of Venous Thromboembolism in Bariatric Surgery Patients

Review of BMI-Based Pharmacologic Protocols for the Prevention of Venous Thromboembolism in Bariatric Surgery Patients

Chlysta W J; Iffland P H; Haller N A

Bariatric Surgical Practice and Patient Care

2014

2014-09

Background: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is an important cause of morbidity and mortality in bariatric surgery patients. The objective of this study was to discuss the evolution of three bariatric surgery VTE prophylaxis protocols and compare safety and effectiveness of each. Methods: A retrospective review of 364 bariatric surgery patients utilizing three different dosing regimens of enoxaparin was completed. Enoxaparin was continued for the duration of the hospital stay in all groups unless hemorrhage was suspected. Sequential compression devices were used during and after surgery. All patients were required to ambulate within 6 h of their procedure. Patients were discharged off all prophylaxis. Results: Inclusive of all groups, two patients (0.5%) developed VTE (p = 0.50), eight patients (2%) required transfusion (p = 0.95), and five patients (1.4%) required reoperation for hemorrhage (p = 0.19). Overallmortality was 0%. Conclusions: A VTE prophylaxis regimen of 40 mg Lovenox subcutaneous (SC) 1-2 h preoperatively followed by 1 mg/body-mass index (rounded to the nearest 10 mg) SC every 12 h until discharge coupled with mechanical VTE prophylaxis is simple, safe, and effective in bariatric surgery patients.

outcomes; Nursing; risk; morbidly obese-patients; y gastric bypass; heparin; enoxaparin; prophylaxis; deep-vein thrombosis; regimens; thromboprophylaxis

Journal Article or Conference Abstract Publication

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