What are the ACCP guidelines for outpatient LMWH therapy for pulmonary embolism (PE)?

Updated: Jun 06, 2019
  • Author: Daniel R Ouellette, MD, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

LMWH can be administered safely in an outpatient setting. This has led to the development of programs in which clinically stable patients with PE are treated at home, at substantial cost savings. The ACCP guidelines suggest that patients with low-risk PE and who have acceptable home circumstances be discharged early from hospital (ie, before the first five days of treatment)(grade 2B).

An international, open-label, randomized trial compared outpatient and inpatient treatment (both using the LMWH enoxaparin as initial therapy) of low-risk patients with acute PE and concluded that outpatient treatment was noninferior to inpatient treatment. [87]


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