What factors affect heparin dosing?
When administration of heparin, the right dose is extremely important, because too little will not have enough anticoagulant effect for the patient's health, while too much can cause bleeding, which could lead to death. The right dose of heparin depends on several factors, including the body's body weight, general condition and active partial thromboplastin (APTT), which is time in seconds that requires blood to be knocked down. Other body weight variables, including adjustments to obese patients, can be used to calculate the heparin -related dosage. Finally, during the administration of a change in the state, the presence of significant bleeding and a change in hemodynamic stability, they may indicate the need to adjust the dosage of heparin. Doctors discussed the use of weight versus non-weidal-based GHT, with the current prevailing opinion in favor of weight-based dosage. Heparin dosing without weight indicates the initial bolus of 5,000 units with an infusion of 1,000 units per hour.
Current weight -based instructions indicate initial bolus administration of 80 units per kilogram of actual body weight (ABW) and maintenance of infusion 18 units per kilogram abw per hour when APTT is less than 35 seconds. Adjustments are made on the basis of regular APPT rating, usually about every six hours. APPT assessment reveals how well heparin works in the body. The number of platelets and a complete number of blood (CBC) can also help determine whether heparin dosage is required.
Another dosing protocol on weight -based heparin is sometimes used on the basis of calculations involving actual body weight and lean body weight in kilograms. The patient's height in the thumbs is calculated. Sixty is deducted from the total number. The answer is multiplied 2.3 and then adds 50 for men and 45 is added for women. The answer is equal to the lean body weight of the patient (LBW) in kilograms.
If ABW is greater than 1.4 times LBW, the patient is considered obese. Another formula is used to take into account the increased volume of the obese patient's blood. In this case, the dosing weight is calculated by taking the difference between ABW and LBW, multiplying the result of 0.4 and adding the result to LBW. Some doctors do not use this formula and state that increased blood volume in the obese patient has a minimum effect on heparin dosage.