Heparin (Unfractionated)
Acute PE/DVT treatment, ACS adjunct, Atrial fibrillation
Indications
- Acute PE/DVT treatment
- ACS adjunct
- Atrial fibrillation
Adult dosing
- pe dvt: dose: 80; unit: units/kg bolus then 18 units/kg/hr; route: IV; weightBased: true; acs: dose: 60; unit: units/kg bolus (max 4000u) then 12 units/kg/hr (max 1000u/hr); route: IV; weightBased: true
Pediatric dosing
- treatment: dose: 75; unit: units/kg bolus then 20 units/kg/hr; route: IV; weightBased: true
Contraindications
- Active major bleeding
- History of HIT
- Severe thrombocytopenia
Clinical pearls
- Target aPTT 1.5-2.5x normal (institution-specific protocol)
- Check aPTT 6 hours after bolus then adjust per institutional nomogram
- Reversal: protamine 1mg per 100 units heparin given in last 2-3 hours
- Weight-based dosing superior to fixed-dose protocols
Source and review
- ACCP Guidelines; AHA/ACC ACS Guidelines. Last reviewed: 2024-11-01