Heparin Resistance — Clinical Perspectives and Management St
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Drug resistance is defined as the lack of expected response to a standard therapeutic dose of a drug or as resistance resulting from biologic changes in the target, as occurs in antibiotic resistance. Heparin resistance, the failure to achieve a specified anticoagulation level despite the use of what is considered to be an adequate dose of heparin, is neither well understood nor well defined.

Heparin resistance usually refers to an effect of unfractionated heparin, for which doses are measured and adjusted, rather than low-molecular-weight heparin, which is not routinely monitored with laboratory testing. Although it is infrequently invoked in inpatient settings, heparin resistance has been reported in critically ill patients with coronavirus disease 2019 (Covid-19) who are at high risk for thrombosis.

This review provides a clinical summary of heparin resistance and potential management strategies.

Source: https://www.nejm.org/doi/full/10.1056/NEJMra2104091?rss=searchAndBrowse