Category: Federal Forum Posters
Purpose: Heparin drips are used in the acute care setting for anticoagulation related to several indications including venous thromboembolism (VTE), myocardial infarction (MI), and bridge therapy. Due to heparin’s narrow therapeutic index, close monitoring is imperative to minimize under or over anticoagulation. Activated partial thromboplastin time (aPTT) was historically the main parameter for heparin monitoring. An alternative method is the antifactor Xa (anti-Xa) heparin assay, which provides a consistent range for monitoring and therefore a higher probability for consistent results and dosing. Our facility moved from an aPTT-based heparin dosing protocol to an antifactor Xa based protocol in September 2017.
Methods: This is a retrospective chart review of the recently implemented antifactor Xa heparin monitoring protocol. All patients who underwent treatment with heparin in the acute care setting between September 2017 and August 2018 will be included in the study. Baseline information that was collected prior to heparin initiation, such as hematocrit, hemoglobin, platelets, antifactor Xa, and PT/PTT, will be recorded. Data related to bolus dosing of heparin, initial heparin infusion rates, dose adjustments, antifactor Xa levels, time between rate changes, time in range, and clinically significant bleeding/clotting events will be analyzed. Secondary outcomes will also be assessed relating to dosing of heparin in morbidly obese patients (BMI > 40 kg/m2). The results of this study will be used to guide any necessary changes to the current protocol and to determine if there have been any significant deviations from the protocol.
Results: Not applicable
Conclusion: Not applicable
Mallory Kuchis– PGY1 Pharmacy Resident, Stratton VA Medical Center, Schenectady, NY