Heparin monogram
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unfractionated heparin nomogram anti-Xa aPTT protocol guidance
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Unfractionated Heparin (UFH) IV Weight-Based Nomogram
| aPTT result | Action |
|---|---|
| Initial | 80 IU/kg IV bolus, then 18 IU/kg/hour infusion |
| <35 sec or <1.2× control | Give 80 IU/kg bolus; increase infusion by 4 IU/kg/hour |
| 35-45 sec or 1.2-1.5× control | Give 40 IU/kg bolus; increase infusion by 2 IU/kg/hour |
| 46-70 sec or 1.5-2.3× control | No change |
| 71-90 sec or 2.3-3× control | Reduce infusion by 2 IU/kg/hour |
| >90 sec or >3× control | Stop infusion for 1 hour, then reduce by 3 IU/kg/hour |
- Recheck aPTT after initiation and after each dose adjustment, commonly at 6-hour intervals until therapeutic, then per local protocol.
- A traditional aPTT treatment target is roughly 1.5-2.5 times control, but the exact therapeutic aPTT range must be calibrated to the laboratory assay. Many hospitals instead use an anti-Xa target of 0.3-0.7 IU/mL.
- Dose caps, indications such as ACS versus VTE, renal function, bleeding risk, and local protocols can differ. Use the hospital-approved nomogram for actual prescribing.
Source: Goldman-Cecil Medicine, Table 68-6 (weight-based IV heparin nomogram), p. 805.
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