Effect of Subcutaneous Unfractionated Heparin Prophylaxis on Activated Partial Thromboplastin Time: A Retrospective Evaluation

J Clin Anesth. 2016 Sep:33:346-50. doi: 10.1016/j.jclinane.2015.11.020. Epub 2016 May 19.

Abstract

Study objective: Characterize the incidence of elevated aPTT results in patients treated with prophylactic, subcutaneous unfractionated heparin (UFH).

Design: Retrospective, cohort analysis.

Setting: Single-center, university hospital.

Measurements: Evaluation of 257 patients with activated partial thromboplastin time (aPTT) testing both prior to and following subcutaneous (SC) unfractionated heparin (UFH) therapy.

Main results: Evaluated patients received UFH 5000 units every 8 hours. Baseline aPTT values were within the normal range (mean±SD, 32.0±8.5 seconds). After initiation of UFH, aPTT values increased (mean±SD, 37.6±15.2 seconds). After 24 hours of SC UFH, mean aPTT values (mean±SD, 38.6±15.5) exceeded the normal laboratory range (23.3-35.7 seconds). An elevated aPTT result after UFH was associated with baseline aPTT, length of therapy, and weight-based UFH dose. A significant association was not identified between aPTT elevation and age, race, sex, history of liver disease, type of admission, or transfusion of blood products.

Conclusions: Treatment with UFH resulted in a small, but significant, increase in aPTT.

Keywords: Activated partial thromboplastin time; Unfractionated heparin; Venous thromboembolism prophylaxis.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Blood Transfusion
  • Cohort Studies
  • Ethnicity
  • Female
  • Heparin / adverse effects*
  • Heparin / therapeutic use
  • Humans
  • Injections, Subcutaneous
  • Intraoperative Complications / prevention & control
  • Liver Diseases / blood
  • Male
  • Middle Aged
  • Partial Thromboplastin Time*
  • Retrospective Studies
  • Sex Characteristics
  • Venous Thromboembolism / prevention & control

Substances

  • Anticoagulants
  • Heparin