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Adjustment of Heparin dose
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| bet | 259/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
| Adjustment of Heparin dose
Anti-Xa is preferred to assess the effect of heparin and guide dosing (Table 1).
Table 1. Heparin dosing based on anti-Xa levels (therapeutic range 0.3-0.7 unit/mL)(modified from O’Meara et al)3
Anti-Xa level (unit/mL)
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Dose adjustment
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<0.2
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Increase infusion by 5 units/kg/hour
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0.2-0.29
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Increase infusion by 5 units/kg/hour
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0.3-0.7
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No change
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>0.7≤1.0
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Decrease infusion by 2 unit/kg/hr
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>1
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Seek advice from haematologist
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Measure anti-Xa levels 6 hours after commencing heparin and then 6 hourly until two consequent values are within therapeutic range. After every heparin adjustment or a blood product administration, the anti-Xa level should be checked again in 6 hours and discuss with haematologist on frequency of further monitoring.
PT/INR, PTT, fibrinogen, platelet count, and ATIII levels are measured daily or as advised by the haematologist.
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If anti-Xa levels are not available, APTT can be used to guide heparin dosing (Table 2).
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