Altho we don't use it where I work, look up the Mass General Protocol (I think they have one - I think I saw it in a study.)
With renal failure, it becomes significant when the RF is moderate-severe - enough to affect plasma proteins, extravascular compartments, etc...
I think they use something close to this:
PTT<39 increase baseline rate by 40%
PTT<40-49 increase baseline by 20%
PTT 50-70 no change
PTT 71-84 decrease by 20%
But....with all these, particularly with comorbid conditions, its difficult to develop a defined protocol when there is just one physician &/or one or two patients. It helps if the physician writes the specific parameters he/she is comfortable with unless it becomes a formulary drug.
Will this be your formulary drug or is this just a one-time thing?
The drug has only been published in a handful of rf pts (altho probably used in lots more than published)..but these folks are followed closely since their extracellular vd can change dramatically & this is where the drug is located.