A Prospective Observational Study on Intravenous Heparin Dosing and Therapeutic Activated Partial Thromboplastin Time (aPTT) in Patients with Cardiovascular Diseases
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 5
Abstract
A prospective observational study was carried out for a period of six months in the Cardiology department of a 700 bedded multispecialty tertiary care teaching hospital. Patients admitted to Cardiovascular Intensive Care Unit (CVICU) and Coronary Care Unit (CCU) of the cardiology department with cardiovascular disease and receiving unfractionated heparin were included in the study. The primary outcome was to understand the practice of heparin dosing in CVD patients in the selected study site and also to monitor the number of patients achieving therapeutic aPTT on Unfractionated Heparin (UFH) during first 6, 24 and 48 hours of admission. The anticoagulant effect of heparin was evaluated by aPTT values obtained. The results obtained were compared with standard dosing guidelines of heparin. The daily doses of heparin administered to the patients were also recorded. The aPTT values of the patients at 6, 24 and 48 hours were evaluated in terms of intensity of anticoagulation and dose adjustment of heparin. Of the 54 patients, aPTT measurements at 6th hour was done for all patients, at least two aPTT measurements were carried out for 31 patients and continuous aPTT measurements were done at 6, 24 and 48 hours only for 19 patients. At 6th hour, thirty-one patients were found to have subtherapeutic aPTT, 15 therapeutic aPTT and 7 supratherapeutic aPTT. At 24th hour, aPTT measurements were done for 31 patients of whom, five showed overanticoagulation. Among the 19 patients who had continuous aPTT monitoring at 6, 24 and 48 hours, five achieved therapeutic range at 48th hour, twelve were in subtherapeutic and 2 in supratherapeutic range. Nineteen adverse drug reactions were reported during the study period.
Authors and Affiliations
Dr. ManjulaDevi . A. S, EstherK. Thomas, Gayathiri G. R, Georgeena George, Ginsy Thankachan
Keywords
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