Computer-Assisted Dosing of Heparin

Abstract

Pharmacy-based, computer-assisted dosing of heparin is feasible and results in faster and more accurate anticoagulant dosing.

Outcomes of Weight‐Based Heparin Dosing Based on Literature Guidelines and Institution Individualization

“…The Rashcke heparin-dosing protocol, based on actual body weight, results in a greater percentage of patients in the supratherapeutic range than another protocol that uses ideal body weight (except for obese patients in whom an adjusted dosing weight is used). 4 Researchers, using linear regression analysis, found that approximately 30% of the variation in heparin requirements was explained by differences in body weight. 13 In addition, older patients tended to require less heparin.…”

“…3 In the past several years, many clinicians proposed a variety of nomograms for heparin dosing to achieve therapeutic aPTTs in a larger percentage of patients sooner. [4][5][6][7][8] Data suggest that in patients with deep vein thrombosis treated with unfractionated heparin, the failure to reach a therapeutic aPTT in the first 24 hours is associated with a markedly increased risk of recurrence. 9,10 Other data refute this claim in deep vein thrombosis 11 ; however, in diseases such as unstable angina, quickly achieving therapeutic anticoagulation may improve outcomes.…”