What are the American College of Chest Physicians (ACCP) and British Committee for Standards in Haematology guidelines for monitoring low molecular weight heparin (LMWH) in the treatment of hereditary and acquired hypercoagulability?

Updated: Jan 05, 2018
  • Author: Paul Schick, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

Guidelines for monitoring of LMWH have been issued by the American College of Chest Physicians [47] and the British Committee for Standards in Haematology. [48] Both organizations indicate that routine monitoring is unnecessary for most patients. However, monitoring to be ascertain that no excess heparin accumulates in the blood should be conducted in patient subgroups such as the following:

  • Overweight and underweight individuals
  • Children
  • Patients with reduced creatinine clearance
  • Patients undergoing prolonged therapy (eg, for cancer)
  • Pregnant women (especially in the third trimester)

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