September 1, 1997Critical Care Medicine

An evaluation of empiric vs. nomogram-based dosing of heparin in an intensive care unit

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Why the study?

Does a weight-based heparin dosing nomogram reduce the time to achieve therapeutic anticoagulation compared to empiric dosing in critically ill patients?

Structured PICO

Does a weight-based heparin dosing nomogram reduce the time to achieve therapeutic anticoagulation compared to empiric dosing in critically ill patients?

Population

Critically ill patients who required full dose anticoagulation as part of treatment of hemodynamic or respiratory failure in an 11-bed medical-surgical intensive care unit of a tertiary, teaching hospital

Intervention

Weight-based dosing nomogram with independent adjustment of heparin infusion rates by nursing staff

Comparator

Prior empiric heparin dosing by physicians

Outcome

Time to achieve a therapeutic activated partial thromboplastin time (PTT) (> 60 secs)surrogate

A weight-based heparin dosing nomogram managed by nurses significantly shortens the time to achieve therapeutic anticoagulation compared to physician empiric dosing in the ICU.

Discussion

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Implication

Nomogram use was associated with faster therapeutic anticoagulation in ICU; hypothesis-generating and requires randomized confirmation before practice change.

Cite This Study

Brown et al. (1997) studied this question.

synapsesocial.com/papers/6a890152d7d3689988760130 https://doi.org/10.1097/00003246-199709000-00021

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Implication

Nomogram use was associated with faster therapeutic anticoagulation in ICU; hypothesis-generating and requires randomized confirmation before practice change.