Instructions for use: Ikus - Berlin Heart
Instructions for use: Ikus - Berlin Heart
Instructions for use: Ikus - Berlin Heart
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Guidelines <strong>for</strong> anticoagulation therapy<br />
Medication - start if... Dosage guidelines Laboratory and target values<br />
UFH<br />
• > 24 h post op<br />
• Platelet count<br />
(>50 k/µl)<br />
• Coagulation<br />
status normal<br />
(TEG)<br />
Vitamin K antagonist<br />
Complete oral nutrition<br />
possible<br />
Inhibition of platelet aggregation<br />
Start with 5 - 7 IU/kg/h<br />
(no bolus)<br />
• depending on<br />
liver function<br />
• At INR > 5:<br />
pa<strong>use</strong><br />
Check aPPT every 6 h<br />
Platelet<br />
count<br />
POD 1,<br />
platelet<br />
count<br />
normal<br />
as of POD<br />
2: < 40 k/µl<br />
as of POD<br />
2: 50 -<br />
100 k/µl<br />
as of POD<br />
2: > 100 k/µl<br />
Target<br />
aPTT<br />
50 - 60 s<br />
normal<br />
22/28 1000095x14 Rev. 8<br />
INR<br />
50 -60 s 1.5 - 2.0<br />
60 -80 s 2.0 - 2.5<br />
• Check INR daily<br />
• Target INR 3.0 - 3.5<br />
• With low INR see LMWH<br />
guidelines (see below)<br />
Collagen serves as control and should not be suppressed. Target value epinephrine: 40 – 50%<br />
Dipyridamole: POD 2 and<br />
ADP > 50%<br />
Aspirin: POD 4, if all<br />
drains and AA > 50%<br />
Clopidogrel: in the event<br />
of resistance to aspirin or<br />
thrombo-embolic<br />
complications<br />
Start with 150 mg/d (up<br />
to 1 g/d)<br />
Start with 50 mg/d<br />
(increase as required)<br />
ADP < 50%<br />
AA < 30%<br />
Start with 75 mg/d ADP < 30%<br />
Tab. 2 Guidelines <strong>for</strong> anticoagulation therapy in young persons and adults
Change language