From the Research
DVT prophylaxis with Lovenox (enoxaparin) can typically be resumed 12-24 hours after bronchoscopy, assuming there were no complications such as significant bleeding. For standard bronchoscopy without biopsy, prophylactic Lovenox can often be restarted the same day in the evening or the following morning 1. However, if biopsies were performed or there was any bleeding during the procedure, it's generally recommended to wait 24-48 hours before restarting anticoagulation. The timing should be individualized based on the patient's bleeding risk versus thrombotic risk. Patients with higher thrombotic risk (history of VTE, active cancer, prolonged immobility) may benefit from earlier resumption, while those with higher bleeding risk may require longer delays.
Key Considerations
- The standard prophylactic dose of Lovenox is 40mg subcutaneously once daily, though dose adjustments may be needed for patients with renal impairment or extreme body weights 1.
- Always consult with the bronchoscopist about specific timing for the individual patient, as they can provide guidance based on what was observed during the procedure.
- A study published in 2020 found that weight-adjusted enoxaparin thromboprophylaxis is feasible and well-tolerated in hospitalized cancer patients 1.
Patient-Specific Factors
- Patients with a history of VTE or active cancer may require earlier resumption of anticoagulation.
- Patients with higher bleeding risk may require longer delays before restarting anticoagulation.
- The decision to restart anticoagulation should be made on a case-by-case basis, taking into account the individual patient's risk factors and medical history.