Bivalirudin rate adjustments protocol.
|Goal aPTT 1.5 – 2 × ULN:|
|Start infusion at 0.15 mg/kg/h, if on dialysis start at 0.07 mg/kg/h|
|For aPTT ≤ 20 goal: increase rate by 20% and repeat aPTT in 2 h|
|For aPTT ≤ 10 goal: increase rate by 10% and repeat aPTT in 2 h|
|For aPTT at goal: continue current rate and repeat aPTT in 4 h|
|For aPTT ≥ 10 goal: decrease rate by 10% and repeat aPTT in 2 h|
|For aPTT ≥ 20 goal: decrease rate by 20% and repeat aPTT in 2 h|
|For aPTT > 100 for two consecutive levels: HOLD drip for 2 h, contact MD, decrease rate by 20% when resumed, and repeat aPTT in 2 h|
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