Control of heparin therapy.

Area of Science:

• Pharmacology
• Hematology

Background:

• Heparin is a widely used anticoagulant.
• Effective heparin therapy requires careful monitoring to prevent bleeding and thrombosis.
• Current laboratory tests aim to guide heparin dosage.

Purpose of the Study:

• To evaluate the efficacy of laboratory tests in controlling heparin therapy.
• To assess the incidence of bleeding complications during heparin treatment.
• To determine if laboratory monitoring can predict bleeding events.

Main Methods:

• A study involving 114 patients receiving heparin therapy.
• Daily monitoring using whole blood coagulation time, kaolin-activated partial thromboplastin time, and plasma heparin assay.
• Recording of bleeding episodes and assessment of pre-therapy hemostatic status.

Main Results:

• Bleeding occurred in 7.6% of patients with normal hemostasis and 50% with defective hemostasis.
• Heparin dosage ranged from 20,000 to 60,000 units/24 hours.
• Positive correlations between the three laboratory tests were weak, and no single test was superior.

Conclusions:

• Laboratory control of heparin therapy is unsatisfactory.
• Patients can bleed despite careful monitoring with current laboratory methods.
• Defective hemostasis significantly increases bleeding risk during heparin therapy.