Table 6.

Heparin anticoagulation strategy

1. Anticoagulation with intravenous unfractionated heparin, preferably applied to the extracorporeal circuit

2. Monitor aPTT or anti-Xa or both

a. To obtain an aPTT of 1.5–2.0 times normal baseline (45–70 s), or anti-Xa activity of 0.3–0.5 UI/mL

3. Initial bolus of heparin

a. 40–80 units/kg PBW

b. Bolus will not be performed in patients already on full anticoagulation

c. Bolus routinely performed when guidewires have been inserted/or after catheter insertion

4. Patients with proven HIT-2

a. Argatroban protocol, e.g. 0.5–2.0 μg/kg/min