Objective: To determine a rational approach to heparin dosing for thromboembolism prophylaxis.
Design: Literature review.
Results: Three commonly used heparin dosing regimens were identified: (1) standard low-dose heparin (5000 U administered subcutaneously 2-3 times per day); (2) adjusted-dose heparin (adequate to elevate the activated partial thromboplastin time to 5 seconds above the upper limit of normal); and (3) low-molecular-weight heparin (30 mg subcutaneously twice daily without monitoring).
Conclusions: Adjusted-dose heparin thromboembolism prophylaxis is both the safest and most reliable method currently available.
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