PMID: 9416380Jan 7, 1998Paper

Reevaluation of a weight-based heparin dosing nomogram: is institution-specific modification necessary?

The Annals of Pharmacotherapy
J R SchlichtR E Smith

Abstract

To compare a heparin dosing nomogram using an initial infusion rate of 18 units/kg/h with physician-directed heparin prescribing and with a modified version of the nomogram adjusted for institution-specific data. During consecutive phases of this cohort study, patients' intravenous heparin therapies were initiated and adjusted by using one of the following three methods: (1) physician-directed dosing, (2) a body weight-based dosing nomogram with an initial infusion rate of 18 units/kg/h, and (3) a body weight-based dosing nomogram with an initial infusion rate determined by the median dose of heparin (in units/kg/h) required to achieve therapeutic activated partial thromboplastin times (aPTTs) during the first two phases. The time required to achieve therapeutic aPTTs as well as the percentage of initial aPTTs in the therapeutic range were compared for the three phases. The heparin dosing nomogram in which the initial infusion rate was adjusted for our individual institution resulted in a statistically shorter median time until aPTTs were in the therapeutic range than did either the physician-directed dosing or unmodified nomogram groups (6.1 h in the modified nomogram group, 10.5 h in the physician-directed group, 21.5 h in th...Continue Reading

References

Feb 1, 1987·The American Journal of Cardiology·K KaplanM Salinger
Jul 15, 1993·Annals of Internal Medicine·P Brill-EdwardsJ Hirsh

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Citations

Aug 9, 2001·Journal of Clinical Pharmacy and Therapeutics·J FolstadC M White
Feb 23, 2010·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Michael L Smith, Kathryn E Wheeler
May 16, 2002·AACN Clinical Issues·Bernadette Porter
May 1, 2010·AACN Advanced Critical Care·Tanya D WilliamsBrook Watts

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