肝素的用量（Dosage of heparin）.docVIP

肝素的用量（Dosage of heparin） There is no specific standard for heparin dosage The general principle is to use as little heparin as possible without the clotting of the pipe and the dialyzer You can make reference to the change of APTT: the value of the 1 hour dialysis should be the base value, and the value at the end of the 180%. should be the 140%. of the underlying value But it should be changed according to the condition of the disease, such as the poor coagulation function, it can be reduced appropriately No obvious bleeding contraindications, the general use of unfractionated heparin: calparine 18---36mg (calparine usually 0.5mg/kg weight) maintenance dose of 4--10mg/h, (but should according to different condition and change). Disable half an hour before dialysis ends. 2, there is bleeding tendency, the use of low molecular weight heparin, 4100 units, without additional. 3, the obvious bleeding, use no heparin, first with heparin 100 mg, add 500 ml of physiological saline, tube for half an hour, then the machine, 15min to 30mim, NS, 100ml, about 1 times the pipeline, rare coagulation. Dialysis patients for the first time: unfractionated heparin: total 1mg/kg, the first dose is 2 / 3. of the total, plus 1 / 3. Low molecular weight heparin: 1mg, unfractionated heparin, =100u, low molecular weight heparin Its nice talking about it: First of all, I have been advocating minimizing heparin: the median we use, the first dose of 20mg, is maintained at 8mg. per hour Second, there are many causes of blood coagulation in extracorporeal circulation, and coagulation should be carefully ruled out. Other reasons, such as residual air in the dialyzer, are easily overlooked There are many non-standard small hospitals, the blind use of large doses of anticoagulant drugs is wrong. We think heparin can be as small as possible, so our dosage of heparin is too small. Patients in 50-60kg usually have the first dose of heparin 15mg, with additional 4-5mg/h. For a small number of patients