scholarly journals Prophylaxis of Thromboembolic Complications in HIP Surgery - A Controlled Trial with low Dose Heparin and Dextran 70

1977 ◽  
Author(s):  
D. Bergqvist ◽  
H.O. Efsing ◽  
T. Hallböök ◽  
T. Hedlund
Keyword(s):  
Pulmonary Embolism ◽  
Hip Fracture ◽  
Low Dose ◽  
Controlled Trial ◽  
Hip Surgery ◽  
Control Group ◽  
X Ray ◽  
Dose Heparin ◽  
Dextran 70 ◽  
Low Dose Heparin

The prophylactic effect of low dose heparin on postoperative thrombosis in general surgery is well established. Dextran 70 has been shown to reduce the frequency of fatal pulmonary embolism. The effect of these prophylactic methods in-hip surgery is debated. The aim of this study was to compare dextran 70, low dose heparin and no treatment in post-traumatic and elective hip surgery. The groups were separately randomized to either prophylaxis. In patients with hip fracture (75 patients) thrombosis was diagnosed with 125I-fibrinogen test. The same diagnostic method was used after elective hip arthroplasty according to Brunswik (96 patients). In the latter group screening for pulmonary embolism was made one week postoperatively with perfusion scintigraphy (Tc-labelled macroaggregated albumin) and x-ray; the diagnosis being based on the combination of a perfusion defect and normal x-ray. The frequency of thrombosis in patients with hip fracture was 67% in the control group, 67% in the low dose heparin group and 40% in the dextran 70 group. The corresponding frequencies for patients undergoing elective hip surgery were 50, 26 and 55%. Pulmonary embolism was seen in 38, 24 and 24% respectively (one fatal embolism in the control group). From this study it can be concluded that only dextran 70 lowers the frequency of thrombosis after hip fracture. Low dose heparin diminishes the frequency of thrombosis in elective hip surgery whereas the two prophylactic methods are equally effective in prophylaxis of pulmonary embolism.

scholarly journals Failure of Low Dose Heparin to Prevent Pulmonary Embolism After Hip Surgery Or Above The Knee Amputation

1978 ◽  
Vol 188 (4) ◽  
pp. 468-474 ◽  
Author(s):  
JAMES W. WILLIAMS ◽  
EDWARD A. EIKMAN ◽  
STEPHEN H. GREENBERG ◽  
J. CARLISLE HEWITT ◽  
ENRIQUE LOPEZ-CUENCA ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Low Dose ◽  
Hip Surgery ◽  
Knee Amputation ◽  
Dose Heparin ◽  
Low Dose Heparin

Prevention or Fatal Postoperative Pulmonary Embolism by Dextran 70 or Low Doses of Heparin, an International Multicentre Trial

1979 ◽  
Author(s):  
T. Brokop ◽  
B. Eklőf ◽  
I. Eriksson ◽  
I. Goldie ◽  
L. Gran ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Low Dose ◽  
Multicentre Trial ◽  
Pulmonary Emboli ◽  
Gynaecological Surgery ◽  
Heparin Group ◽  
Dose Heparin ◽  
Dextran 70 ◽  
Skin Erythema ◽  
Low Dose Heparin

The efficacy of dextran 70 or low dose heparin in preventing fatal postoperative pulmonary embolism was investigated in a multicentre randomized trial. 4352 patients over the age of 40 years undergoing elective major general, orthopaedic, urological or gynaecological surgery were included in the trial. The two groups were well matched for age, sex, weight and diagnosis. 75 patients died within 30 days after operation, 38 in the dextran and 37 in the heparin group. Autopsy frequency was 87 and 86% respectively. 5 patients in the dextran and 3 in the heparin group had pulmonary emboli as the only cause of death and 1 patient in the dextran and 3 in the heparin group had emboli which had contributed to death. The two methods of prevention thus seem to be equally effective in reduction of lethal pulmonary emboli. 2 cases with incidental pulmonary emboli were found in thex-tran and 4 in the heparin group. Wound haematoma and incomplete prophylaxie was more common in the heparin than in the dextran group. In 6 patients in the dextran and 94 in the heparin group prophylaxis was stopped due to bleeding. Side-effects occurred in 22 patients after dextran and in J patients aiter heparin. Most patients had mild reactions (skin erythema etc.) but in 5 dextran cases reactions were classified as severe.

Low-Dose Heparin Prophylaxis Against Fatal Pulmonary Embolism

1975 ◽  
Author(s):  
V. V. Kakkar ◽  
T. P. Corrigan
Keyword(s):  
Pulmonary Embolism ◽  
Low Dose ◽  
Massive Pulmonary Embolism ◽  
Control Group ◽  
Fatal Pulmonary Embolism ◽  
Heparin Group ◽  
Essential Information ◽  
Dose Heparin ◽  
Low Dose Heparin ◽  
Heparin Prophylaxis

Several controlled trials have shown that low-dose heparin is effective in reducing the incidence of deep vein thrombosis without increasing the risk of bleeding. However its effectiveness in preventing fatal pulmonary embolism has yet to be determined and, for this, a multicentre tiral was organised in which 31 centres took part; patients over the age of 40, undergoing only major elective abdominal, thoracic or orthopaedic surgery were included. They were randomly allocated to a control or heparin group and, for each patient entered in the trial, essential information was recorded in a proforma designed for computer analysis. The incidence of fatal pulmonary embolism was determined by autopsy examination. 4,121 patients were admitted to the trial – 2,076 in the control group and 2,045 in the heparin group. 16 patients in the control group died due to acute massive pulmonary embolism confirmed at autopsy, but only 2 in the heparin group. The difference is statistically significant (P < 0.01). There was no evidence of excessive blood loss during or after surgery. These results will be presented in detail. Low-dose heparin prophylaxis can now be recommended as the method of choice for preventing postoperative fatal pulmonary embolism.

scholarly journals Incidences of fatal postoperative pulmonary embolism after prophylaxis with dextran 70 and low-dose heparin: an international multicentre study.

BMJ ◽  
1980 ◽  
Vol 280 (6207) ◽  
pp. 69-72 ◽  
Author(s):  
U F Gruber ◽  
T Saldeen ◽  
T Brokop ◽  
B Eklof ◽  
I Eriksson ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Multicentre Study ◽  
Low Dose ◽  
Dose Heparin ◽  
Dextran 70 ◽  
Low Dose Heparin

Low-Dose Heparin and Deep-Vein Thrombosis after Total Hip Replacement

1976 ◽  
Vol 36 (01) ◽  
pp. 157-164 ◽  
Author(s):  
P. M Mannucci ◽  
Luisa E. Citterio ◽  
N Panajotopoulos
Keyword(s):  
Deep Vein Thrombosis ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Low Dose ◽  
Control Group ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Deep Vein ◽  
Low Dose Heparin

SummaryThe effect of subcutaneous low-dose heparin on postoperative deep-vein thrombosis (D. V. T.) (diagnosed by the 125I-labelled fibrinogen test) has been investigated in a trial of 143 patients undergoing the operation of total hip replacement. Two randomized studies were carried out: in one the scanning for D.V.T. was carried out daily for 7 days post operatively and in the other for 15 days. In both, the incidence of D.V.T. was significantly lower in the heparin-treated patients (P<0.005). Bilateral D.V.T. was also prevented (P<0.05), through the extension of D.V.T. to the distal veins of the thigh was not significantly reduced. Heparin treatment was, however, followed by a higher incidence of severe postoperative bleeding (P< 0.02) and wound haematoma formation (P< 0.005), and the postoperative haemoglobin was significantly lower than in the control group (P<0.005). A higher number of transfused blood units was also needed by the heparin treated patients (P<0.001).

Prophylaxis Against Postoperative Thromboembolic Complications. A Comparison Between Dextran 70, Dihydroergotamin Heparin and a Sulphated Polysaccarid

1979 ◽  
Author(s):  
D. Bergqvist ◽  
T. Hallböök ◽  
B. Lindblad
Keyword(s):  
Elective Surgery ◽  
Hip Surgery ◽  
Perfusion Scintigraphy ◽  
X Ray ◽  
Vein Thrombosis ◽  
Dextran 70 ◽  
Postoperative Thrombosis ◽  
Fibrinogen Test ◽  
Deep Vein ◽  
Low Dose Heparin

Dextran 70, a fixed combination of dihydroergotamine and low dose heparin (DHEH) and a sulphated polysaccarid (PZ68B) have been compared for prevention of postoperative thromboembolism. The trial has been prospective with separate randomization of patients undergoing elective general surgery, elective hip surgery and hip frecture surgery. Deep vein thrombosis has teen diagnosed with the 125 I-fibrinogen test. In patients undergoing elective hip surgery pulmonary x-ray and perfusion scintigraphy have been made preoperatively and on postoperative day 7, The patients have been followed for 30 days to detect late fatal pulmonary emboli. 253 patients have been studied -(34 exclusions), the main results being as follows:In conclusion there is a good and equal prophylactic effect against postoperative thrombosis of DHEH and PZ68E in elective surgery, and the two methods are as effective as dextran 70 in hip fracture patients.

Low-dose heparin for the prevention of post-ERCP pancreatitis: a randomized placebo-controlled trial

2008 ◽  
Vol 22 (9) ◽  
pp. 1971-1976 ◽  
Author(s):  
O. Barkay ◽  
E. Niv ◽  
E. Santo ◽  
R. Bruck ◽  
A. Hallak ◽  
...  
Keyword(s):  
Low Dose ◽  
Controlled Trial ◽  
Dose Heparin ◽  
Low Dose Heparin
Sign in / Sign up

Export Citation Format

Share Document