UW Medicine Standard Protocols – Initiation Dosing
1. Order standard heparin infusion with starting dose defaulted based on indication.
2. Order Loading Bolus, if warranted.
3. Order goal anti-Xa level (low intensity 0.3-0.5 units/mL or regular intensity 0.3-0.7 units/mL).
4. Order as needed Re-Bolus for subtherapeutic anti-Xa, if warranted.
| INDICATION |
LOADING BOLUS (maximum 10,000 units) |
INITIAL INFUSION DOSE |
PRN RE-BOLUS FOR LOW ANTI-Xa LEVEL (maximum 5,000 units) |
FIRST ANTI-Xa LEVEL |
| Treatment of Acute Thrombosis
(e.g., DVT, PE) |
80 units/kg | 18 units/kg/hr |
Anti-Xa 0.1-0.29 units/mL: Anti-Xa < 0.1 units/mL: |
6 hours after starting infusion |
| Atrial Fibrillation, Valve Replacement, Peri-Procedural Bridging | 70 units/kg | 15 units/kg/hr | ||
| Acute Coronary Syndrome | 50 units/kg | 12 units/kg/hr | ||
| Mechanical Circulatory Support | None | 15 units/kg/hr | None | |
| Acute Ischemic Stroke | None | 12 units/kg/hr | ||
| Ultra Low Intensity Heparin
(anti-Xa goal 0.1-0.3) |
None | 8 units/kg/hr |
