Table 6 Heparin anticoagulation strategy
From: ECCO2R therapy in the ICU: consensus of a European round table meeting
1. Anticoagulation with intravenous unfractionated heparin, preferably applied to the extracorporeal circuit | |
2. Monitor aPTT or anti-Xa or both | |
a. To obtain an aPTT of 1.5–2.0 times normal baseline (45–70 s), or anti-Xa activity of 0.3–0.5 UI/mL | |
3. Initial bolus of heparin | |
a. 40–80 units/kg PBW | |
b. Bolus will not be performed in patients already on full anticoagulation | |
c. Bolus routinely performed when guidewires have been inserted/or after catheter insertion | |
4. Patients with proven HIT-2 | |
a. Argatroban protocol, e.g. 0.5–2.0 μg/kg/min |