Pediatric Stroke: A Review

Table 4

Protocol for systemic heparin administration and adjustment in children.

Stage	aPTT (sec)	Dose (units/kg)	Hold (min)	Rate change (%)	Repeat aPTT
(I) Loading dose		75 IV over 10 min
(II) Initial maintenance dose
Infants < 1 yo		28/h
Children > 1 yo		20/h
(III) Adjustment	<50	50	0	10	4 h
	50–59	0	0	10	4 h
	60–85	0	0	0	Next day
	86–95	0	0	−10	4 h
	96–120	0	30	−10	4 h
	>120	0	60	−15	4 h
(IV) Obtain blood for aPTT 4 h after heparin load and 4 h after every infusion rate change
(V) When apt values are in therapeutic range, perform daily CBC and apt measurement

Adapted from Roach et al. [88]