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Related Experiment Videos

Intravenous heparin dosing: patterns and variations in internists' practices

B M Reilly1, R Raschke, S Srinivas

  • 1University of Rochester School of Medicine and Dentistry, New York.

Journal of General Internal Medicine
|October 1, 1993
PubMed
Summary

Physicians" dosing of intravenous heparin varies widely due to a lack of standard guidelines. This variability in heparin dosing may affect anticoagulation effectiveness, necessitating studies on standardized protocols.

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Area of Science:

  • Internal Medicine
  • Pharmacology
  • Clinical Practice

Background:

  • Intravenous heparin is a critical anticoagulant.
  • Standardized dosing protocols for heparin are lacking.
  • Variability in heparin dosing practices can impact patient outcomes.

Purpose of the Study:

  • To characterize internists' current practices in administering and adjusting intravenous heparin.
  • To identify variations in therapeutic ranges and dosing adjustments among physicians.

Main Methods:

  • A survey was administered to 61 attending physicians in internal medicine across three hospitals.
  • Physicians' choices regarding therapeutic activated partial thromboplastin time (APTT) ranges, initial bolus and infusion doses, and dose adjustments were recorded.

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  • Responses were analyzed based on different APTT level categories.

    • Main Results:

    • Significant variability was observed in internists' heparin dosing decisions and therapeutic APTT ranges.
    • Responses to non-therapeutic APTT levels showed high coefficients of variation.
    • Two distinct groups of physicians emerged, utilizing mutually exclusive therapeutic ranges and differing in dosing strategies.

    Conclusions:

    • Wide variations in internists' intravenous heparin dosing practices exist in the absence of standardized guidelines.
    • These inconsistent practices may hinder timely and effective anticoagulation.
    • Further research comparing standardized heparin dosing protocols is recommended.