Table 3.20-3. Protocol of IV unfractionated heparin dose adjustment based on aPTT

aPTT (s)a

IV bolus

Continuous IV infusion

First dose

80 IU/kg

18 IU/kg/h

<35 (<1.2 × control)

80 IU/kg

Increase by 4 IU/kg/h

35-45 (1.2-1.5 × control)

40 IU/kg

Increase by 2 IU/kg/h

46-70 (1.5-2.5 × control)b

Without IV injection

No change

71-90 (2.5-3 × control)

Without IV injection

Reduce by 2 IU/kg/h

>90 (>3 × control)

Without IV injection

Stop the infusion for 1 h, then reduce by 3 IU/kg/h

a Sample numerical values expressed in seconds may vary depending on the reference (control) values in a given laboratory.

b The therapeutic aPTT range of 46-70 s should correspond to the anti-Xa activity of 0.3-0.7 IU/mL. Note: Repeat aPTT and adjust the unfractionated heparin dose after 6 hours.

aPTT, activated partial thromboplastin time; IV, intravenous.