Approach to heparin resistance during systemic anticoagulation for CPB*

CPB: cardiopulmonary bypass; ACT: activated whole blood clotting time; ATIII: antithrombin III cofactor; FFP: fresh frozen plasma.
* Refer to UpToDate content on management of CPB for details regarding heparin administration and monitoring, and management of heparin resistance.
¶ Wait three minutes after each heparin dose to obtain blood to check ACT value.
Δ Fixed dosing regimen for heparin administration during CPB:100 to 150 units/kg per hour (or 50 units/kg every 30 minutes if duration of CPB will be brief).