Unfractionated heparin reversal: Difference between revisions
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*Stop transfusion | *Stop transfusion | ||
*Observation alone may be appropriate in less severe cases | *Observation alone may be appropriate in less severe cases | ||
*Protamine | *[[Protamine]] | ||
**Only indicated for major bleeding (0.2% of patients develop severe anaphylaxis) | **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 1mg IV for every 100 units of UFH infused in the prior 3hr | ||
| Line 18: | Line 18: | ||
**Because half-life is short (7 min) may require second treatment | **Because half-life is short (7 min) may require second treatment | ||
*Massive bleed | *Massive bleed | ||
**Cryoprecipitate (10 U IV), then [[FFP]] (& platelets, aminocaproic acid infusion if nec) | **Cryoprecipitate (10 U IV), then [[FFP]] (& platelets, aminocaproic acid infusion if nec) | ||
==Disposition== | ==Disposition== | ||
Revision as of 16:14, 19 October 2016
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)