|
Dosing must be individualized according to diagnosis, patient weight and other clinical considerations. The guidelines below are to be used at the physician’s discretion and are not meant to determine the course of therapy.
Scientific data indicates that clinical efficacy and safety is optimized if the PTT is maintained at 1.5 to 2.5 times the control.
(Hirsh J. Heparin. MEHM 1991; 324: 1565-75)
|
APTT
(seconds)
|
Bolus Dose
|
Stop Infusion (minutes)
|
Rate Change Units/hour
|
Repeat APTT
|
|
< 40
|
5,000 u
|
0
|
Increase 150 u/hr
|
6 hours after change
|
|
40 – 49
|
2,000 u
|
0
|
Increase 100 u/hr
|
6 hours after change
|
|
50 – 70
|
0
|
0
|
No change
|
6 hours then next a.m. and q a.m. if in range
|
|
71 – 80
|
0
|
0
|
Decrease 50 u/hr
|
6 hours after change
|
|
81 – 100
|
0
|
30
|
Decrease 100 u/hr
|
6 hours after restart
|
|
> 100 – 150
|
0
|
60
|
Decrease 150 u/hr
|
6 hours after restart
|
|
> 150
|
0
|
60
|
Decrease 200 u/hr
|
6 hours after restart
|
|
