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Heparin dosage and the time to achieve APTT target

作者:Hua Luo   发布时间:2012-09-18 08:19:53   浏览次数:625
Initial study of heparin dosage and the time to achieve APTT target in pulmonary thromboembolism
 
LUO Hua ICU of Peking university Shenzhen HospitalShenzhen 518036ChinaLIANG YingDepartment of Pulmonary Medicine, Beijing Anzhen Hospital, affiliated Hospital of Capital University of Medical Science, Beijing 100029,China
 
AbstractObjecktive By using 13u/h/kg of heparin as initial dosage to treat Chinese PTE, to evaluate prospectively maintenance dosage and the time when APTT achieve therapeutic target .Methods In 25 PTE cases,the value of APTT and heparin concentration before and every 6 h after therapy were recorded sequently. The rate to achive APTT target on 24 hours, 48 hours and 72 hours after 13u/h/kg initiation were caculated respectively. Time to achive APTT target steadly was determined. Total requirement dosage and maintenance dosage of heparin among all individuals were reckoned when APTT reached therapeutic range. The linear relationship between heparin concentration and APTT, between heparin dosage and APTT were analyzed separately with correlation and regression model of single variable. Results The maintenance dosage of all averaged 12.43±2.58 u/h/kg (95% CI 11.37~13.50 u/h/kg) and which were 11.52±2.71u/h/kg and 11.01~11.36 u/h/kg in regression formula. Who treated with 11~13 u/h/kg of maintenance dosage had most great rate to reach APTT target, 37% and 32% respectively, within 24h and 72h after beginning anticoagulation. 75% of all individuals who use 11~13 u/h/kg as maintenance dosage achieve APTT target on first day and then 100% of them did on the following day. All individuals who began with 13 u/h/kg and ajusted dosage according to Raschke nomogram suceed in 76%,96% and 100% of rate to reach APTT target on 24h, 48h and 72h seperately. In which, nobody had APTT over therapeutic range on first day. The median of hour to reach APTT target was 18 and the mode was 12. Conclusions Average maintenance dosages of all cases in this study ranged from 11 to 13 u/h/kg. 76% of all individiuls beginning with 13 u/h/kg reached APTT therapeutic target within the first 24h. The median of hours to achive APTT target in all individiuls was 18.
Key Words  HeparinAPTTPulmonary embolism
Anticoagulation therapy  






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