Prediction of Heparin Requirements in Acute Thromboplastic Venous Disease

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Abstract
• It has been suggested that early heparin requirements are greater in patients with acute deep venous thrombosis (DVT) and pulmonary embolism (PE). Heparin requirements were recorded for 73 patients with suspected DVT and PE. The maintenance dosage (days 1 through 4) of heparin sodium required to achieve therapeutic partial thromboplastin times (PTTs) was significantly higher in patients with DVT (n=54; mean ± SD dosage, 1,151±246 units/hr) compared with patients with no DVT (n=19; mean± SD dosage, 952±190 units/ hr). The first posttreatment PTT was significantly lower in patients with DVT (mean ± SD PTT, 68.74± 27.96 s) compared with control patients (mean ± SD PTT, 89.41±23.25 s). This study supports the clinical impression that initial heparin requirements are greater and heparin clearance is more rapid in patients with acute DVT and PE. (Arch Surg 1985;120:436-438)