Document Detail


In unfractionated heparin dosing, the combination of patient age and estimated plasma volume predicts initial antifactor Xa activity better than patient weight alone.
MedLine Citation:
PMID:  9855319     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To determine whether patient factors other than body weight would better predict patients' initial antifactor Xa heparin activity (HA) after start of unfractionated heparin (UFH) therapy. DESIGN: Case series. SETTING: A 625-bed, adults-only, private, tertiary care teaching hospital. PATIENTS: Ninety-two patients requiring UFH therapy. INTERVENTIONS: Patients received initial UFH bolus doses of 72-80 U/kg ideal weight and initial UFH infusions of 19.1-21.2 U/kg ideal weight. MEASUREMENTS AND MAIN RESULTS: Fifty-five percent of the first 6-hour HA measurements were supratherapeutic (> 0.7 U/ml antifactor Xa activity). Patient weight was inferior to a combination of age and estimated plasma volume in predicting initial HA. A predictive model including these two factors accounted for 38.5% of variation in first HA levels compared with 17.7% with actual weight alone. CONCLUSION: Weight-based UFH dosing may frequently result in nontherapeutic initial HA levels. Initial UFH dosing might be improved if protocols based on patient age and estimated plasma volume were developed.
Authors:
T K Rosborough
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pharmacotherapy     Volume:  18     ISSN:  0277-0008     ISO Abbreviation:  Pharmacotherapy     Publication Date:    1998 Nov-Dec
Date Detail:
Created Date:  1999-02-10     Completed Date:  1999-02-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8111305     Medline TA:  Pharmacotherapy     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1217-23     Citation Subset:  IM    
Affiliation:
Medical Education Department, Abbott Northwestern Hospital, Minneapolis, Minnesota 55407, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Anticoagulants / administration & dosage*,  pharmacokinetics
Body Height
Body Mass Index
Body Weight*
Creatinine / blood
Dose-Response Relationship, Drug
Female
Hematocrit
Heparin / administration & dosage*,  blood,  pharmacokinetics
Humans
Linear Models
Male
Middle Aged
Time Factors
Chemical
Reg. No./Substance:
0/Anticoagulants; 60-27-5/Creatinine; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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