Non–weight-based enoxaparin dosing subtherapeutic in trauma patients

Abstract Background We report our experience dosing and monitoring enoxaparin with anti-factor Xa activity (anti-FXaA) levels for venous thromboembolism prophylaxis in trauma patients (TP). Materials and methods TP receiving standard, non–weight-based dosed enoxaparin administered every 12 h for venous thromboembolism prophylaxis with peak anti-FXaA levels measured were prospectively monitored and evaluated and those whose first anti-FXaA levels ≥ or Results Of the fifty-one TP included, initial anti-FXaA levels were versus 0.45 [0.39–0.48] mg/kg, P  = 0.003). Thirty-seven TP achieved anti-FXaA level ≥0.2 IU/mL (23 requiring dose increases) at a dose of 0.49 [0.44–0.54] mg/kg. Correlation between dose and anti-FXaA levels for the initial 51 anti-FXaA levels ( r  = 0.360, P  = 0.009) and for all 103 anti-XaA levels ( r  = 0.556, P Conclusions Non–weight-based enoxaparin dosing did not achieve target anti-FXaA levels in most TP. Higher anti-FXaA levels correlated with larger weight-based enoxaparin doses. Weight-based enoxaparin dosing (i.e., 0.5 mg/kg subcutaneously every 12 h) would better achieve target anti-FXaA levels.