Unfractionated heparin using actual body weight without dose capping in obese pediatric patients—Subgroup analysis from an observational cohort study

To evaluate the correlation between an uncapped, actual body weight‐based unfractionated heparin dosing strategy, we performed a body mass index‐based subanalysis of a previously reported pediatric cohort. Nearly half (45%) of obese patients were supra‐therapeutic on initial anti‐FXa assessment. Obese patients achieved therapeutic anti‐FXa significantly faster than nonobese patients (median 4 vs 12 hours, P  = .0192) and were more likely to have any supra‐therapeutic anti‐FXa levels (77% vs 35%; P  = .0021). There was no statistically significant difference in major or clinically relevant nonmajor bleeding rates between weight categories ( P  = .69). Prospective pediatric studies are warranted to confirm our findings.