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This topic will review the general principles underlying the therapeutic use of unfractionated and LMW heparins including dosing, Treatment and prevention of heparin-induced thrombocytopenia: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133:340S.
16 Jan 2016 The aPTT, which measures the function of the intrinsic and common clotting pathways, is the most commonly used laboratory test to monitor heparin. A recent review identified the potential advantages of the heparin anti-Xa level over the aPTT for heparin monitoring.
Despite being a cornerstone of anticoagulation, UFH is limited by its unpredictable pharmacokinetic profile, which makes close laboratory monitoring necessary. The most common methods for monitoring UFH are the activated partial thromboplastin time (aPTT) and antifactor Xa heparin assay (anti-Xa HA), but both present
The following are guidelines for the commencement and maintenance of Unfractionated Heparin (UFH) infusions, also known as Standard Heparin. It may be necessary to modify this Clinical Haematology consultation is recommended to determine ongoing monitoring requirements. For most patients one APTT assay

Executive Summary. Guideline Overview. This clinical practice guideline is intended to provide a standardized process for the initiation, maintenance and monitoring of intravenous unfractionated heparin. Practices considered include guidance on selection of dosing nomograms, initial and maintenance monitoring of.
13 Jul 2007 These patients will frequently appear to have heparin resistance, requiring higher doses of UFH to achieve a therapeutic response.9,11 .. current recommendations on the use of anti–factor Xa heparin levels should be expanded, since UFH therapy monitored with heparin levels may be more effective and
The treatment of venous thromboembolism is the setting in which most monitoring of heparin therapy occurs. The aPTT and anti-FXa assays are generally used for monitoring. However, neither reflects the anti-thrombotic mechanism of UFH in the patient or directly reflects the level of active drugs in the blood. Monitoring is
Unfractionated Heparin (UFH) for systemic anticoagulation. - ADULTS. The following guideline is approved only for use at University College London. Hospitals NHS Monitoring. • After each dose change, wait 6 hours before taking blood for the next APTT ratio (unless APTT ratio > 4.1 in which case refer to table above).
Splenic vein thrombosis is rarely diagnosed acutely and when discovered it is often not treated with anticoagulant therapy. thrombosis should be considered for treatment with heparin. If UFH is used it may be at low dose or at a therapeutic dose sufficient to prolong the APTT ratio to twice that of normal (grade C).
     

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