From the Research
Temporarily stopping a heparin (unfractionated heparin) intravenous infusion for 15 minutes does not increase the risk of bleeding. In fact, brief interruptions of heparin infusions are common in clinical practice and are generally considered safe. Unfractionated heparin has a very short half-life of approximately 60-90 minutes, and its anticoagulant effect begins to diminish quickly once the infusion is stopped. A 15-minute interruption is too brief to significantly affect the therapeutic anticoagulation level in most patients.
Key Points to Consider
- The half-life of unfractionated heparin is approximately 60-90 minutes, as noted in studies such as 1, which found a terminal half-life of 54 minutes.
- Brief interruptions of heparin infusions are common and generally considered safe, with the anticoagulant effect diminishing quickly after the infusion is stopped.
- When resuming the infusion after a short pause, it's typically appropriate to continue at the same rate without requiring a new bolus dose, unless the interruption is several hours long, which might require reassessment of coagulation status or consideration of a new bolus.
- Healthcare providers should document the interruption and monitor the patient appropriately, but a 15-minute pause represents minimal clinical concern for either increased bleeding risk or loss of therapeutic effect.
Clinical Implications
The short half-life of heparin is why continuous infusions are used in the first place - to maintain stable anticoagulation levels. Given the findings from studies like 1, which demonstrated the efficient and safe effect of unfractionated heparin administered by continuous infusion for hemodialysis anticoagulation, the clinical practice of briefly interrupting heparin infusions is supported.
Monitoring and Documentation
Healthcare providers should be vigilant in monitoring patients after any interruption of heparin infusion, including brief pauses, and document these events appropriately. However, based on the evidence, such as the study 1, a 15-minute pause is not expected to significantly impact the patient's bleeding risk or therapeutic anticoagulation level.