Suboptimal Monitoring and Dosing of Unfractionated Heparin
Authors: Kevin K. Chung, Jeanne K. Tofferi, William T. Browne
Journal: Annals of Internal Medicine (2004)

Letters6 April 2004Suboptimal Monitoring and Dosing of Unfractionated HeparinKevin K. Chung, MD, Jeanne K. Tofferi, MD, MPH, and William T. Browne, MDKevin K. Chung, MDFrom Dwight D. Eisenhower Army Medical Center, Augusta, GA 30905.Search for more papers by this author, Jeanne K. Tofferi, MD, MPHFrom Dwight D. Eisenhower Army Medical Center, Augusta, GA 30905.Search for more papers by this author, and William T. Browne, MDFrom Dwight D. Eisenhower Army Medical Center, Augusta, GA 30905.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-7-200404060-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Raschke and colleagues (1) addressed inappropriate dosing of unfractionated heparin in most clinical trials. We recently completed an audit of the use of unfractionated heparin at our institution and discovered many problems besides the lack of correlation of the therapeutic range of activated partial thromboplastin time (aPTT) to an anti–factor Xa heparin level of 0.3 to 0.7 IU/mL.First, many physicians were not using the recommended weight-based method of delivery with the bolus of 80 U/kg of body weight and the maintenance dosage of 18 U/kg per hour (2). This caused 23.1% of our treated patients to ...References1. Raschke R, Hirsh J, Guidry JR. Suboptimal monitoring and dosing of unfractionated heparin in comparative studies with low-molecular-weight heparin. Ann Intern Med. 2003;138:720-3. [PMID: 12729426] LinkGoogle Scholar2. Raschke RA, Reilly BM, Guidry JR, Fontana JR, Srinivas S. The weight-based heparin dosing nomogram compared with a “standard care” nomogram. A randomized, controlled trial. Ann Intern Med. 1993;119:874-81. [PMID: 8214998] LinkGoogle Scholar3. Cruickshank MK, Levine MN, Hirsh J, Roberts R, Siguenza M. A standard heparin nomogram for the management of heparin therapy. Arch Intern Med. 1991;151:333-7. [PMID: 1789820] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Dwight D. Eisenhower Army Medical Center, Augusta, GA 30905. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Weight-based Heparin Dosing Nomogram Compared with a Standard Care Nomogram Robert A. Raschke , Brendan M. Reilly , James R. Guidry , Joseph R. Fontana , and Sandhya Srinivas Suboptimal Monitoring and Dosing of Unfractionated Heparin in Comparative Studies with Low-Molecular-Weight Heparin Robert Raschke , Jack Hirsh , and James R. Guidry Suboptimal Monitoring and Dosing of Unfractionated Heparin Robert Raschke , Jack Hirsh , and James R. Guidry Metrics Cited byTreatment of thrombosisHeparin dosing and therapeutic activated partial thromboplastin times (aPTT) in acute coronary syndrome (ACS) 6 April 2004Volume 140, Issue 7Page: 582KeywordsBlood plasmaBody weightClinical trialsHeparinLow molecular weight heparinPartial thromboplastin time ePublished: 6 April 2004 Issue Published: 6 April 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...