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Critically ill children and adults Presence of lupus anticoagulant Pregnancy Deficiencies of contact system factors (factor XII, kallikrein, high-molecular-weight-kininogen) Special populations receiving low-molecular-weight heparin Suspected heparin resistance: > 35,000 U of unfractionated heparin required over 24 hours, or total daily dose exceeding estimated weight-based requirement Antithrombin deficiency Increased heparin clearance Concomitant use of aprotinin and nitroglycerin Children Very elderly (age > 85) Extreme body weight
(< 40 kg, and > 144 kg in the case of enoxaparin)Chronic kidney disease
(creatinine clearance 15–30 mL/min)Pregnancy (especially with a mechanical heart valve)
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- Article
- ABSTRACT
- UNFRACTIONATED HEPARIN AND WARFARIN ARE STILL WIDELY USED
- UNFRACTIONATED HEPARIN’S EFFECT IS UNPREDICTABLE
- MONITORING UNFRACTIONATED HEPARIN IMPROVES OUTCOMES
- THE aPTT REFLECTS THROMBIN INHIBITION
- HEPARIN ASSAYS MEASURE UNFRACTIONATED HEPARIN ACTIVITY
- ANTI-Xa ASSAY VS THE aPTT
- CLINICAL APPLICABILITY OF THE ANTI-Xa ASSAY
- LIMITATIONS OF ANTI-Xa ASSAYS
- ANTI-Xa ASSAYS AND LOW-MOLECULAR-WEIGHT HEPARINS
- ANTI-Xa ASSAYS IN PATIENTS RECEIVING DIRECT ORAL ANTICOAGULANTS
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