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. 2021 Sep 25;157(3):321–327. doi: 10.1093/ajcp/aqab135

Table 4.

Institutional Heparin Dosing Protocol Based on Activated Partial Thromboplastin Time Values

Indication
Venous Thrombosis Cardiac CNS or Postpartum Thrombosis
Starting dose
Bolus 80 U/kg 70 U/kg None
Starting rate 18 U/kg/h 15 U/kg/h 12 U/kg/h
Monitoring Check aPTT 6 h after UFH initiation
Dose adjustments by aPTT, s
<64 Bolus: 30 U/kg Bolus: None
Infusion: Increase rate by 3 U/kg/h Infusion: Increase rate by 3 U/kg/h
Monitoring: Repeat aPTT in 6 h Monitoring: Repeat aPTT in 6 h
64-70 Bolus: 30 U/kg Bolus: None
Infusion: Increase rate by 3 U/kg/h Infusion: Increase rate by 2 U/kg/h
Monitoring: Repeat aPTT in 6 h Monitoring: Repeat aPTT in 6 h
71-105 No change
Monitoring: Repeat aPTT with next day’s labs
106-116 Infusion: Decrease rate by 1 U/kg/h
Monitoring: Repeat aPTT in 6 h
117-132 Infusion: Decrease rate by 2 U/kg/h
Monitoring: Repeat aPTT in 6 h
≥133 Infusion: Hold for 1 h; at restart, decrease rate by 2 U/kg/h
Monitoring: Repeat aPTT in 6 h

aPTT, activated partial thromboplastin time; CNS, central nervous system; UFH, unfractionated heparin.