PMID- 20172987
OWN - NLM
STAT- MEDLINE
DCOM- 20100524
LR  - 20220410
IS  - 1535-2900 (Electronic)
IS  - 1079-2082 (Linking)
VI  - 67
IP  - 5
DP  - 2010 Mar 1
TI  - Weight-based heparin protocol using antifactor Xa monitoring.
PG  - 371-4
LID - 10.2146/ajhp090123 [doi]
AB  - PURPOSE: The performance of a weight-based dosing protocol for unfractionated 
      heparin (UFH) infusions using antifactor Xa monitoring was evaluated. METHODS: 
      The first 50 patients to receive a UFH infusion per the new protocol for over 24 
      hours, regardless of indication, were included in the analysis. All patients 
      received a bolus dose of 26 units/kg, followed by an i.v. infusion of 15 
      units/kg/ hr based on actual body weight, with no maximum dosage. Antifactor Xa 
      levels were measured every 6 hours after infusion initiation and after every rate 
      change until stable, defined as two consecutive results within the target range 
      of 0.3-0.7 unit/mL, and every 24 hours thereafter. If a level was outside of the 
      target range, the infusion rate was adjusted. Primary outcomes measured included 
      the percentage of patients with a target level at the first test (obtained 6 
      hours after the start of therapy) and within the first 24 hours. The success of 
      the protocol in obese patients versus nonobese patients was also analyzed. 
      RESULTS: Of the 50 patients enrolled, 26 (52%) achieved a target antifactor Xa 
      concentration 6 hours after infusion initiation. Only 4 patients did not have an 
      antifactor Xa concentration in the target range within 24 hours. Of the 17 
      patients weighing more than 100 kg, 16 (94%) had a value within the target range 
      within 24 hours. CONCLUSION: A weight-based UFH dosing nomogram using antifactor 
      Xa monitoring resulted in a high percentage of patients achieving target 
      antifactor Xa values within the first 24 hours of therapy.
FAU - Smith, Michael L
AU  - Smith ML
AD  - Department of Pharmacy Services, William W. Backus Hospital, 326 Washington 
      Street, Norwich, CT 06360, USA. msmith@wwbh.org
FAU - Wheeler, Kathryn E
AU  - Wheeler KE
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - England
TA  - Am J Health Syst Pharm
JT  - American journal of health-system pharmacy : AJHP : official journal of the 
      American Society of Health-System Pharmacists
JID - 9503023
RN  - 0 (Anticoagulants)
RN  - 0 (Antithrombins)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.21.6 (Factor Xa)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/administration & dosage/*blood
MH  - Antithrombins/metabolism
MH  - Blood Chemical Analysis/*methods
MH  - Body Weight
MH  - *Clinical Protocols
MH  - Drug Dosage Calculations
MH  - Drug Monitoring/*methods
MH  - Factor Xa/*analysis
MH  - Female
MH  - Heparin/administration & dosage/*blood
MH  - Humans
MH  - Infusions, Intravenous
MH  - Male
MH  - Middle Aged
MH  - Nomograms
MH  - Obesity/blood
EDAT- 2010/02/23 06:00
MHDA- 2010/05/25 06:00
CRDT- 2010/02/23 06:00
PHST- 2010/02/23 06:00 [entrez]
PHST- 2010/02/23 06:00 [pubmed]
PHST- 2010/05/25 06:00 [medline]
AID - 67/5/371 [pii]
AID - 10.2146/ajhp090123 [doi]
PST - ppublish
SO  - Am J Health Syst Pharm. 2010 Mar 1;67(5):371-4. doi: 10.2146/ajhp090123.