Anti-factor Xa Levels (Enoxaparin)

Standard dosing (enoxaparin 30q12h) may be inadequate in high risk trauma; lead to inc rates of DVT

Monitor antifactor Xa level

  • Normal value = <0.1
  • >0.5 considered therapeutically anticoagulated
  • 0.2 to 0.5 considered target level for prophylaxis

–Send trough before 4th dose

  • If normal –>increase to 40mg q12h; then 50 sq q12h or even 60 q12h

–With this approach, majority of patients require enoxaparin in 40 q12h dose

(Marino)

Patients with morbid obesity or renal failure may require monitoring of Anti-Xa levels.

– anti-Xa levels in plasma should be measured 4 hours after LMWH administration

– desired anti-Xa level = 0.6-1.0 units/mL for BID dosing and >1 unit/mL for OD dosing

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