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Heparin infusion for ECMO/VAD

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Heparin infusion in infants on ECMO

ACT (sec)  Bolus (u/kg) Stop Infusion  (min) % Rate Change
<120
120 - 140
140 - 160
160 - 180
180 - 200
200 - 220
>220
50
30
20
0
0
0
0
0
0
0
0
0
30
60
+15%
+10%
+10%
0
-10%
-10%
-10%

Heparin Infusion in infants on VAD

ACT (sec)  Bolus (u/kg) Stop Infusion (min) % Rate Change
<100
100 - 120
120 - 140
140 - 160
160 - 180
180 - 200
>200
50
30
20
0
0
0
0
0
0
0
0
0
30
60
+15%
+10%
+10%
0
-10%
-10%
-10%


Heparin should never be reduced to less than 10u/kg/hr unless ACT>200 for more than 4-6 hours and approved by intensivist.

Platelet transfusions - give 10u/kg bolus and increase infusion rate by 10%. If on several occasions the ACT falls below goal during or immediately after platelets, consider giving 20u/kg and increasing infusion by 20%.

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Document Control

  • Date last published: 31 October 2005
  • Document type: Clinical Guideline
  • Services responsible: Paediatric Intensive Care Unit
  • Editor: John Beca
  • Review frequency: 2 years