Prevention Of Deep Vein Thrombosis In Medical Patients By Low Dose Subcutaneous Heparin

1981 ◽  
Author(s):  
J J F Belch ◽  
G D O Lowe ◽  
A G Ward ◽  
C D Forbes ◽  
C R M Prentice
Keyword(s):  
Heart Failure ◽  
Deep Vein Thrombosis ◽  
Low Dose ◽  
Randomised Trial ◽  
Medical Patients ◽  
Chest Infection ◽  
Vein Thrombosis ◽  
Subcutaneous Heparin ◽  
Patients With Heart Failure ◽  
Deep Vein

In recent years it has been repeatedly shown that low-dose subcutaneous heparin reduces the incidence of deep vein thrombosis (D.V.T.) after major general surgery. By comparison, the prevention of thrombosis in medical patients has been little studied. A randomised trial was undertaken in one hundred patients with heart failure and/or chest infection to determine whether low-dose subcutaneous heparin reduced the frequency of D.V.T. in the legs. Heparin (5000 units 8 hourly), started within 12 hours of admission to hospital and continued until the patient was fully mobile, significantly reduced the frequency of D.V.T. diagnosed by the 125I- fibrinogen scan technique, from 26% to 4% (p<0.01). Heparin did not cause bleeding problems except for a 20% incidence of injection site bruising. We therefore recommend prophylaxis with low dose subcutaneous heparin in patients with heart failure or chest infection who require more than 3 days’ bed rest.

Prevention of Deep Vein Thrombosis in Medical Patients by Low-Dose Heparin

1981 ◽  
Vol 26 (2) ◽  
pp. 115-117 ◽  
Author(s):  
Jill J. Belch ◽  
G. D. O. Lowe ◽  
Agnes G. Ward ◽  
C. D. Forbes ◽  
C. R. M. Prentice
Keyword(s):  
Heart Failure ◽  
Deep Vein Thrombosis ◽  
Low Dose ◽  
Randomised Trial ◽  
Medical Patients ◽  
Chest Infection ◽  
Vein Thrombosis ◽  
Subcutaneous Heparin ◽  
Patients With Heart Failure ◽  
Deep Vein

A randomised trial was undertaken in one hundred patients with heart failure and/or chest infection to determine whether low-dose subcutaneous heparin reduced the frequency of deep vein thrombosis (DVT) in the legs. Heparin, (5000 units 8 hourly) significantly reduced the frequency of DVT, diagnosed by the125I-fibrinogen scan technique, from 26 to 4 per cent (p < 0.01). Heparin was started within 12 hours of admission to hospital and continued until the patient was fully mobile. Heparin did not cause bleeding problems except for a 20 per cent incidence of injection site bruising. We therefore recommend prophylaxis with low-dose subcutaneous heparin in patients with heart failure or chest infection who require more than three days bed rest.

Low-dose subcutaneous heparin in prevention of deep-vein thrombosis

1972 ◽  
Vol 10 (23) ◽  
pp. 89-91
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Low Dose ◽  
Fatal Pulmonary Embolism ◽  
Vein Thrombosis ◽  
Subcutaneous Heparin ◽  
Prevention And Treatment ◽  
Deep Vein ◽  
Low Dosage

Earlier this year1 we discussed the prevention and treatment of venous thrombosis and concluded that heparin in low dosage seemed the most promising drug for preventing deep-vein thrombosis postoperatively, although the optimum regimen was not yet known. Sharnoff and his associates who began this work 10 years ago claim to have shown that this treatment largely prevents fatal pulmonary embolism.2

Low-dose perioperative heparin: a survey of its use

1974 ◽  
Vol 12 (15) ◽  
pp. 59-60
Keyword(s):  
Deep Vein Thrombosis ◽  
Low Dose ◽  
Vein Thrombosis ◽  
Subcutaneous Heparin ◽  
Deep Vein

Two years ago we discussed the value of various measures, including low-dose subcutaneous heparin, in the prevention of deep-vein thrombosis.1 We concluded that heparin used in this way lowers the incidence of deep-vein thrombosis after most major operations and that it is safe, cheap and simple to administer. Subsequent experience summarised in this issue has confirmed these conclusions. How widely is this treatment now used?

The Hemodynamic and Fibrinolytic Response to Low Dose Epinephrine and Phenylephrine Infusions During Total Hip Replacement Under Epidural Anesthesia

1992 ◽  
Vol 68 (04) ◽  
pp. 436-441 ◽  
Author(s):  
Nigel E Sharrock ◽  
George Go ◽  
Robert Mineo ◽  
Peter C Harpel
Keyword(s):  
Heart Rate ◽  
Deep Vein Thrombosis ◽  
Cardiac Index ◽  
Total Hip Replacement ◽  
Epidural Anesthesia ◽  
Hip Replacement ◽  
Low Dose ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryLower rates of deep vein thrombosis have been noted following total hip replacement under epidural anesthesia in patients receiving exogenous epinephrine throughout surgery. To determine whether this is due to enhanced fibrinolysis or to circulatory effects of epinephrine, 30 patients scheduled for primary total hip replacement under epidural anesthesia were randomly assigned to receive intravenous infusions of either low dose epinephrine or phenylephrine intraoperatively. All patients received lumbar epidural anesthesia with induced hypotension and were monitored with radial artery and pulmonary artery catheters.Patients receiving low dose epinephrine infusion had maintenance of heart rate and cardiac index whereas both heart rate and cardiac index declined significantly throughout surgery in patients receiving phenylephrine (p = 0.0001 and p = 0.0001, respectively). Tissue plasminogen activator (t-PA) activity increased significantly during surgery (p <0.0005) and declined below baseline postoperatively (p <0.005) in both groups. Low dose epinephrine was not associated with any additional augmentation of fibrinolytic activity perioperatively. There were no significant differences in changes in D-Dimer, t-PA antigen, α2-plasmin inhibitor-plasmin complexes or thrombin-antithrombin III complexes perioperatively between groups receiving low dose epinephrine or phenylephrine. The reduction in deep vein thrombosis rate with low dose epinephrine is more likely mediated by a circulatory mechanism than by augmentation of fibrinolysis.

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