Effects on Coagulation and Fibrinolysis of Desmopressin in Patients Undergoing Total Hip Replacement

1991 ◽  
Vol 66 (06) ◽  
pp. 652-656 ◽  
Author(s):  
Per Anders Flordal ◽  
Karl-Gösta Ljungström ◽  
Jan Svensson ◽  
Brenda Ekman ◽  
Gustaf Neander
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Bleeding Time ◽  
Antithrombin Iii ◽  
Postoperative Bleeding ◽  
Double Blind ◽  
Total Hip ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Coagulation And Fibrinolysis

SummaryTwelve patients undergoing total hip replacement, with regional anaesthesia and with dextran infusion for plasma expansion and thromboprophylaxis, were given the vasopressin analogue desmopressin (DDAVP) or placebo in a randomized, double-blind prospective study. In controls (n = 6) we found a prolongation of the bleeding time, low factor VIII (FVIII) and von Willebrand factor (vWF) and a decrease in antithrombin III to levels known to be at risk for venous thrombosis. Desmopressin shortened postoperative bleeding time, gave an early FVIII/vWF complex increase, prevented antithrombin III from falling to critically low values and appeared to activate the fibrinolytic system, both by tPA increase and PAI-1 decrease.Thus in the controls we found changes in both coagulation and fibrinolysis indicating a haemorrhagic diathesis as well as a risk for thromboembolism. Desmopressin induced factor changes that possibly reduce both risks.

scholarly journals Aspirin-Persantin Prophylaxis in Elective total hip Replacement

1977 ◽  
Author(s):  
A.J. Silvergleid ◽  
R. Bernstein ◽  
D.S. Burton ◽  
J.B. Tanner ◽  
J.F. Silverman ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Treated Group ◽  
Control Group ◽  
Double Blind ◽  
Total Hip ◽  
Blind Area ◽  
Effective Prophylaxis ◽  
Clinically Significant ◽  
To Receive

A prospective, double-blind clinical study was performed to evaluate the combination of dipyridamole(Persantin)225 mg/day and acetyl salicyclic acid (ASA) 1 g/day prophylaxis of post-operative venous thromboembolism in elective total hip replacement. Patients were stratified according to age, and randomly assigned to receive drug or placebo. All patients were followed with 125I-labelledfibrinogen scanning for one week post-operatively, or until fully mobile. Venography was performed in 67/129 patients; in 27 patients the venogram was obtained to confirm a positive fibrinogen scan, in 40 patients an elective venogram was obtained on the 7th post-operative day to evaluate the operated thigh (a blind area for scanning). Thrombosis (by scan or venogram) was found in 16/66(24%) in the control group, and in 21/63(33%) in the treated group. Overall incidence was 37/129 (29%). Correlation of scan with venography was 90%. There were no clinically significant pulmonary emboli in either group. We conclude that the combination of ASA and dipridamole as given in this study is not effective prophylaxis in elective total hip replacement.

Sequential intrapulmonary and systemic activation of coagulation and fibrinolysis during and after total hip replacement surgery

1993 ◽  
Vol 70 (6) ◽  
pp. 451-458 ◽  
Author(s):  
Ola E. Dahl ◽  
Trude Pedersen ◽  
Peter Kierulf ◽  
Åse-Britt Westvik ◽  
Per Lund ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Total Hip ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Coagulation And Fibrinolysis

Changes In Biologically And Immunochemically Measured Antithrombin III (At III) In Total HIP Replacement With Special Regard To Type Of Thromboembolic Prophylaxis

1981 ◽  
Author(s):  
H O Fredin ◽  
L Tengborn
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Antithrombin Iii ◽  
Screening Method ◽  
Chromogenic Substrate ◽  
Thromboembolic Prophylaxis ◽  
Total Hip ◽  
At Iii ◽  
Lung Scanning

The plasma levels of AT III were studied in 71 patients operated with total hip replacement. AT III was determined with amidolytic assay using the chromogenic substrate Coatest S-2238 (KabiDiagnostica, Sweden) as well as electroimmunochemically. Samples were drawn before the operation and 4-5 times the first week postoperatively. The results were adjusted to the hematocrit (Hcr) for each sample.The patients were randomly allocated to thromboprophylactic prevention with either Macrodex (Pharmacia, Sweden) or heparin with dihydroergotamine (Sandoz, Switzerland). Phlebography of the operated leg and perfusion/ventilation lung scanning was performed on the 10-14th postoperative day.Results. No difference in the AT III levels were seen in patients who developed postoperatively deep venous thrombosis and/or pulmonary embolism (DVT/PE) as compared to those who did not develop DVT/PE.No decrease of AT III was found postoperatively, when adjusted to HcrThe frequency of DVT/PE did not differ significantly between the two types of thromboembolic prophylaxis.Conclusion. Pre-operative determination of AT III, whether biologically or immunochemically, did not seem to be successful as screening method of patients to develop DVT/PE.

Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement: a randomised, double-blind, non-inferiority trial

The Lancet ◽  
2007 ◽  
Vol 370 (9591) ◽  
pp. 949-956 ◽  
Author(s):  
Bengt I Eriksson ◽  
Ola E Dahl ◽  
Nadia Rosencher ◽  
Andreas A Kurth ◽  
C Niek van Dijk ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Dabigatran Etexilate ◽  
Double Blind ◽  
Total Hip

Alterations in Plasma Antithrombin III Following Total Hip Replacement and Elective Cholecystectomy

2009 ◽  
Vol 24 (2) ◽  
pp. 101-104 ◽  
Author(s):  
Kaj Anker Jørgensen ◽  
Erik Stoffersen ◽  
Per J. Sørensen ◽  
Steen Ingeberg ◽  
Mogens Hüttel ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Antithrombin Iii ◽  
Total Hip ◽  
Elective Cholecystectomy

An Attempt at Predicting Postoperative Deep Vein Thrombosis by Preoperative Coagulation Studies in Patients Undergoing Total Hip Replacement

1980 ◽  
Vol 43 (03) ◽  
pp. 194-197 ◽  
Author(s):  
Dennis W T Nilsen ◽  
Miladin Jeremic ◽  
Odd K Weisert
Keyword(s):  
Deep Vein Thrombosis ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Antithrombin Iii ◽  
Fibrinogen Level ◽  
Additional Parameter ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Uptake Test ◽  
Deep Vein

SummaryPreoperative levels of fibrinogen, factors V, VII, VIII and antithrombin III were measured in 25 consecutive patients undergoing total hip replacement. Deep vein thrombosis (D.V.T.) was detected by fibrinogen-uptake test in 60% of the patients. The preoperative fibrinogen level was significantly higher (p < 0.05), and serum antithrombin III was markedly lower (p ≦ 0.1) in patients with postoperative D.V.T. The quotient of fibrinogen to serum antithrombin III was significantly higher (p < 0.01) in patients with D.V.T. This quotient may serve as an additional parameter to other clinical and laboratory tests in prediction of postoperative D.V.T. following hip surgery.

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