Defining heparin resistance: communication from the ISTH SSC Subcommittee of Perioperative and Critical Care Thrombosis and Hemostasis.

dc.contributor.author

Levy, Jerrold H

dc.contributor.author

Sniecinski, Roman M

dc.contributor.author

Rocca, Bianca

dc.contributor.author

Ghadimi, Kamrouz

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Douketis, James

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Frere, Corinne

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Helms, Julie

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Iba, Toshiaki

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Koster, Andreas

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Lech, Tara K

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Maier, Cheryl L

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Neal, Mathew D

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Scarlestscu, Ecatarina

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Spyropoulos, Alex

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Steiner, Marie E

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Tafur, Alfonso J

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Tanaka, Kenichi A

dc.contributor.author

Connors, Jean M

dc.date.accessioned

2024-01-10T16:56:19Z

dc.date.available

2024-01-10T16:56:19Z

dc.date.issued

2023-12

dc.description.abstract

The term heparin resistance (HR) is used by clinicians without specific criteria. We performed a literature search and surveyed our SSC membership to better define the term when applied to medical and intensive care unit patients. The most common heparin dosing strategy reported in the literature (53%) and by survey respondents (80.4%) was the use of weight-based dosing. Heparin monitoring results were similar based on the proportion of publications and respondents that reported the use of anti-Xa and activated partial thromboplastin time. The most common literature definition of HR was >35 000 U/d, but no consensus was reported among survey respondents regarding weight-based and the total dose of heparin when determining resistance. Respondent consensus on treating HR included antithrombin supplementation, direct thrombin inhibitors, or administering more heparin as the strategies available for treating HR. A range of definitions for HR exist. Given the common use of heparin weight-based dosing, future publications employing the term HR should include weight-based definitions, monitoring assay, and target level used. Further work is needed to develop a consensus for defining HR.

dc.identifier

S1538-7836(23)00641-4

dc.identifier.issn

1538-7933

dc.identifier.issn

1538-7836

dc.identifier.uri

https://hdl.handle.net/10161/29710

dc.language

eng

dc.publisher

Elsevier BV

dc.relation.ispartof

Journal of thrombosis and haemostasis : JTH

dc.relation.isversionof

10.1016/j.jtha.2023.08.013

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

Humans

dc.subject

Thrombosis

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Heparin

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Antithrombins

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Anticoagulants

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Partial Thromboplastin Time

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Critical Care

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Communication

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Hemostasis

dc.title

Defining heparin resistance: communication from the ISTH SSC Subcommittee of Perioperative and Critical Care Thrombosis and Hemostasis.

dc.type

Journal article

duke.contributor.orcid

Levy, Jerrold H|0000-0003-3766-4962

duke.contributor.orcid

Ghadimi, Kamrouz|0000-0002-9287-7541

pubs.begin-page

3649

pubs.end-page

3657

pubs.issue

12

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Anesthesiology

pubs.organisational-group

Anesthesiology, Cardiothoracic

pubs.organisational-group

Surgery

pubs.organisational-group

Surgery, Cardiovascular and Thoracic Surgery

pubs.publication-status

Published

pubs.volume

21

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