Article ID Journal Published Year Pages File Type
2762123 Journal of Clinical Anesthesia 2016 5 Pages PDF
Abstract

•Neuraxial catheters improve postoperative pain but are contraindicated with anticoagulation.•Subcutaneous unfractionated heparin prophylaxis may elevate aPTT.•We examine aPTT values prior to and during prophylactic subcutaneous heparin therapy.•Prophylactic subcutaneous heparin caused a small, but significant, increase in aPTT.

Study ObjectiveCharacterize the incidence of elevated aPTT results in patients treated with prophylactic, subcutaneous unfractionated heparin (UFH).DesignRetrospective, cohort analysis.SettingSingle-center, university hospital.MeasurementsEvaluation of 257 patients with activated partial thromboplastin time (aPTT) testing both prior to and following subcutaneous (SC) unfractionated heparin (UFH) therapy.Main ResultsEvaluated patients received UFH 5000 units every 8 hours. Baseline aPTT values were within the normal range (mean ± SD, 32.0 ± 8.5 seconds). After initiation of UFH, aPTT values increased (mean ± SD, 37.6 ± 15.2 seconds). After 24 hours of SC UFH, mean aPTT values (mean ± SD, 38.6 ± 15.5) exceeded the normal laboratory range (23.3–35.7 seconds). An elevated aPTT result after UFH was associated with baseline aPTT, length of therapy, and weight-based UFH dose. A significant association was not identified between aPTT elevation and age, race, sex, history of liver disease, type of admission, or transfusion of blood products.ConclusionsTreatment with UFH resulted in a small, but significant, increase in aPTT.

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