[CK] Heparin infusion protocol @ VCU

Initial bolus
60units/kg(4000 max)
12unit/kg/hr for infusion(1000 max = 10ml/hr as 25000units/ 250ml)
Repeat stat 4 or 6

70-90 goal
<40 = +1.6 and check in 4 hours
otherwise = +1.2(<55), +0.8(goal)
                    -1.6(>130), -1.2(<116), -0.8(<100)

every 15
change 0.8 or 1.2 or 1.6

>150 = turn off and aptt hourly until aptt < 100 then
resume -2ml/hr from the point of turning off
recheck ptt in 6hours. \\\

cf>
DVT/PE protocol
bolus
80(10000 max)
16/kg/hr(1600 max)
much higher bolus and infusion
BUT
nomogram will be similar.

REF>

http://portal.vcuhs.mcvh-vcu.edu/mcvh/home/PharmacyServices/NomogramsProtocolsGuidelines/HeparinNomograms.pdf