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Unfractionated heparin reversal
From WikEM
Contents
Background
- Managed according to clinical severity, NOT PTT value
- Heparin-associated bleeding is not always reflected by a supratherapeutic PTT
Clinical Features
Differential Diagnosis
Workup
Management
- Stop transfusion
- Observation alone may be appropriate in less severe cases
- Protamine
- Only indicated for major bleeding (0.2% of patients develop severe anaphylaxis)
- Give 1mg IV for every 100 units of UFH infused in the prior 3hr
- Give slowly over 1-3min; do not exceed 50mg in any 10 minute period
- Because half-life is short (7 min) may require second treatment
- Massive bleed
- Cryoprecipitate (10 U IV), then FFP (& platelets, aminocaproic acid infusion if nec)
