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Initial Full-Dose Heparin For Adult: 1-Venous Thromboembolism (DVT/PE), Treatment

This document provides guidelines for initial full-dose heparin therapy for adults. It outlines protocols for venous thromboembolism (DVT/PE) treatment and atrial fibrillation (ACS). For VTE, it recommends an IV bolus of 80 units/kg followed by an 18 unit/kg/hr infusion, adjusting the dose based on aPTT levels every 6 hours. For ACS, it recommends an IV bolus of 60 units/kg (max 4000 units) followed by a 12 unit/kg/hr infusion, adjusting based on PTT levels and maintaining the PTT within the therapeutic range.

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239 views3 pages

Initial Full-Dose Heparin For Adult: 1-Venous Thromboembolism (DVT/PE), Treatment

This document provides guidelines for initial full-dose heparin therapy for adults. It outlines protocols for venous thromboembolism (DVT/PE) treatment and atrial fibrillation (ACS). For VTE, it recommends an IV bolus of 80 units/kg followed by an 18 unit/kg/hr infusion, adjusting the dose based on aPTT levels every 6 hours. For ACS, it recommends an IV bolus of 60 units/kg (max 4000 units) followed by a 12 unit/kg/hr infusion, adjusting based on PTT levels and maintaining the PTT within the therapeutic range.

Uploaded by

Lam
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Initial Full-Dose Heparin for Adult

Prior to heparin therapy, draw baseline aPTT, PT, CBC and weigh patient.
Make all calculations using total body weight ______kg.

1-Venous thromboembolism (DVT/PE), treatment


IV bolus 80 units/kg in 5minutes then infusion at 18 units/kg/hour in D5W
2-Measure aPTT 6 hrs after bolus dose
3-Adjust heparin dose using the scale below 
aPTT result Action Next aPTT

aPTT <35 seconds (<1.2 x control) 80 units/kg bolus, then increase infusion rate 6 hours after I.V bolus
by 4 units/kg per hour
aPTT 35 to 45 seconds (1.2 to 1.5 x 40 units/kg bolus, then increase infusion rate 6 hours after I.V bolus
control) by 2 units/kg per hour
aPTT 46 to 70 seconds¶ (1.5 to 2.3 x No change (therapeutic range) 6 hours (when two
control) consecutive values are
within therapeutic
range, then next aPTT
in morning)
aPTT 71 to 90 seconds (2.3 to 3.0 x Decrease infusion rate by 2 units/kg per 6 hours
control)
hour

aPTT >90 seconds (>3.0 x control) Hold infusion 1 hour, then decrease infusion 6 hours
rate by 3 units/kg per hour
Initial Full-Dose Heparin for Adult

3-Cardiology (ACS-Atrial fibrillation)

1- IV bolus of 60 units/kg in 5minutes (maximum: 4,000 units)

2- Infusion 12 units/kg/hour as continuous infusion in D5W

4-Adjust heparin using the scale below - NOTE: ACS Protocol uses max bolus dose of 5000 units and a
maximum infusion rate of 1000 units/hr.

PTT: Dosing Adjustment:

< 31 Increase Infusion rate by 3 units/kg/hr and Rebolus with 60 units/kg 

31-37 Increase Infusion rate by 2 units/kg/hr

38-61 Maintain infusion rate

62-80 Decrease  Infusion rate by 2 units/kg/hr

81-114 Hold heparin for 1 hour and reduce Infusion rate by 3 units/kg/hr

>114 Hold infusion immediately

5- Order PTT 6 hours after any dose change, and adjust infusion until PTT is within the therapeutic range. When 2
consecutive PTT’s are therapeutic, order PTT (and adjust heparin drip as needed) daily with morning labs. 

Reference :

 Online lexi-comp 2018


 globalrph.com
 Antithrombotic Therapy for VTE Disease CHEST Guideline and Expert Panel Report
Initial Full-Dose Heparin for Adult

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