Cleveland Clinic, Division of Cardiovascular Medicine, Cleveland, OH 44115, USA.
Expert Opin Drug Saf. 2011 Jan;10(1):77-84. doi: 10.1517/14740338.2011.521150. Epub 2010 Sep 25.
Unfractionated heparin is an anticoagulant used in the treatment of myocardial infarction, pulmonary embolism and other thrombotic disorders. However, with anticoagulation comes the risk of bleeding and adverse events. These risks increase with supratherapeutic dosing.
In this review, we discuss the reasons for supratherapeutic dosing, and the incidence of adverse events and clinical consequences of the same, with a focus on heparin use in acute coronary syndromes. We also provide some opportunities for safer use of intravenous heparin. At the end of this article, the reader should have a better understanding of the proper use of heparin as well as the magnitude of bleeding and a respect for its consequences.
Heparin is an indispensable anticoagulant used in a number of clinical scenarios. Careful attention must be paid to dosing in order to minimize the risk of bleeding and related adverse events including death. The use of weight-based nomograms is paramount. Devices to automate testing and titration are currently under development.
未分级肝素是一种抗凝剂，用于治疗心肌梗死、肺栓塞和其他血栓性疾病。然而，抗凝治疗伴随着出血和不良事件的风险。这些风险随着治疗剂量的增加而增加。
在这篇综述中，我们讨论了治疗剂量过高的原因，以及不良事件的发生率和相同剂量的临床后果，重点是肝素在急性冠状动脉综合征中的应用。我们还提供了一些更安全使用静脉肝素的机会。阅读完本文后，读者应该更好地理解肝素的正确使用方法，以及出血的严重程度和对其后果的重视。
肝素是一种在许多临床情况下不可或缺的抗凝剂。为了将出血和相关不良事件（包括死亡）的风险降到最低，必须注意剂量。基于体重的剂量表至关重要。目前正在开发用于自动检测和滴定的设备。
