HNF dosificación/ajuste dosis TTPa
For patients receiving alteplase, tenecteplase, or reteplase
for fibrinolysis in acute MI, we recommend administration of weight-adjusted
heparin (60 U/kg bolus for a max. of 4,000 U) followed by 12 U/kg/h (1,000 U/h
max.) adjusted to maintain an aPTT 50 to 75 s for 48 h (Grade
1C). CHEST 2004 |
For patients aged <= 75 years with
preserved renal function (creatinine <= 2.5 mg/dL in male and <= 2.0
mg/dL in female patients), we suggest use of enoxaparin
(30-mg bolus IV followed by 1 mg/kg SC q12h) with
tenecteplase up to
7 days (Grade 2B). CHEST 2004 |
|
MODIFICACIÓN PERFUSIÓN DE HEPARINA Na SEGÚN TTPA
Dilución heparina Na : 250 mg. en 500 ml de SG.
5%. o SF.
|
• concentracion =50 U /ml |
⇒25 ml/h (
300 mg/24 h) |
⇒20 ml/h (
240 mg/24 h) |
⇒1mg = 100
U. |
|
AJUSTE INFUSIÓN DE HEPARINA SEGÚN
TTPA |
TTPa" |
VELOCIDAD DE INFUSIÓN |
NUEVO CONTROL |
< 50
|
4000 U. bolo + 2 ml/h
|
6 horas
|
50 - 75
|
0
|
sin control/ 24 horas
|
75 - 95
|
-1 ml/h
|
6 horas
|
96 -120 |
suspender 30 min. -2
ml/h
|
6 horas
|
> 120
|
suspender 60 min. -3
ml/h
|
6 horas.
|
|
|
|
|