{Reference Type}: Journal Article
{Title}: Clinical guidance for unfractionated heparin dosing and monitoring in critically ill patients.
{Author}: Samimi MN;Hale A;Schults J;Fischer A;Roberts JA;Dhanani J;
{Journal}: Expert Opin Pharmacother
{Volume}: 25
{Issue}: 8
{Year}: 2024 Jun 7
{Factor}: 4.103
{DOI}: 10.1080/14656566.2024.2364057
{Abstract}: <B>UNASSIGNED: </B>Unfractionated heparin is a widely used anticoagulant in critically ill patients. It has a well-established safety profile and remains an attractive option for clinicians due to its short half-life and reversibility. Heparin has a unique pharmacokinetic profile, which contributes to significant inter-patient and intra-patient variability in effect. The variability in anticoagulant effect combined with heparin's short half-life mean close monitoring is required for clinical efficacy and preventing adverse effects. To optimize heparin use in critically ill patients, effective monitoring assays and dose adjustment strategies are needed.<BR><B>UNASSIGNED: </B>This paper explores the use of heparin as an anticoagulant and optimal approaches to monitoring in critically ill patients.<BR><B>UNASSIGNED: </B>Conventional monitoring assays for heparin dosing have significant limitations. Emerging data appear to favor using anti-Xa assay monitoring for heparin anticoagulation, which many centers have successfully adopted as the standard. The anti-Xa assay appears have important benefits relative to the aPTT for heparin monitoring in critically ill patients, and should be considered for broader use.