Effect of Low-Dose heparin and dihydroercotamine prophylaxis on incidence of postoperative deep-vein thrombosis in patients undergoing hip surgery

1979 ◽  
Author(s):  
G. Lahnborg ◽  
B. Beerman
Keyword(s):  
Low Dose ◽  
Prospective Trial ◽  
Favourable Effect ◽  
Control Group ◽  
Heparin Group ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Deep Vein ◽  
Low Dose Heparin ◽  
Heparin Prophylaxis

The favourable effect of low-dose heparin prophylaxis in preventing postoperative deep-vain thrombosis (DVT) in patients undergoing surgical treume has bean shown in several investigations. However, there are still some patients sustaining DVT in spite of heparin prophylaxis. In an attempt to improve the prophylaxis, dihydroergotamine (DHE) has been added to the heparin.In a prospective trial the effect of low-dose heparin and DHE prophylaxis was studied in 190 patients undergoing nailing of fractured femoral neck. The patients were divided into 3 groups and were randomly given heparin or a combination of heparin and DHE and the third group was given only saline.The frequency of DVT, detected by the 125-I-fibrinogen method was 167. in the group given heparin and DHE, 20%, in the heparin group and 39% in the control group.Preliminary results. Completed evaluation will be presented during the congress.

Deep vein thrombosis and low-dose heparin prophylaxis in neurosurgical patients

1978 ◽  
Vol 49 (3) ◽  
pp. 378-381 ◽  
Author(s):  
Dario Cerrato ◽  
Cesare Ariano ◽  
Folco Fiacchino
Keyword(s):  
Deep Vein Thrombosis ◽  
Low Dose ◽  
Motor Deficit ◽  
Control Group ◽  
Heparin Group ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Deep Vein ◽  
Low Dose Heparin ◽  
Heparin Prophylaxis

✓ By the use of 125I-labeled fibrinogen test, the incidence of postoperative deep vein thrombosis (DVT) and the effectiveness of prophylactic low-dose heparin treatment were investigated in 110 patients who underwent elective neurosurgical procedures. Fifty patients were appointed randomly to a control group and 50 to a heparin group (10 patients were excluded since they had DVT before surgery). The incidence of DVT was reduced from 34% in the control group to 6% in the heparin group (p < 0.005). No statistically significant differences were observed in transfusion requirements, postoperative hemoglobin concentration, and the occurrence of postoperative hematomas between the two groups. Positive correlation was observed between DVT and motor deficit (p < 0.05). Preoperative assessment of patients' sensitivity to the standard 5000-unit dose of heparin was performed in all treated patients and is thought an important factor in improving the safety of heparin prophylaxis.

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).

LOW-DOSE HEPARIN PROPHYLAXIS AGAINST DEEP-VEIN THROMBOSIS AFTER ACUTE STROKE

The Lancet ◽  
1978 ◽  
Vol 311 (8056) ◽  
pp. 160-161
Author(s):  
O.J.S. Buruma ◽  
A.R. Wintzen ◽  
E. Briët
Keyword(s):  
Deep Vein Thrombosis ◽  
Acute Stroke ◽  
Low Dose ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Deep Vein ◽  
Low Dose Heparin ◽  
Heparin Prophylaxis

Randomized study of adjusted versus fixed low dose heparin prophylaxis of deep vein thrombosis in hip surgery

1989 ◽  
Vol 76 (9) ◽  
pp. 933-935 ◽  
Author(s):  
D. A. Taberner ◽  
L. Poller ◽  
J. M. Thomson ◽  
G. Lemon ◽  
F. J. Weighill
Keyword(s):  
Deep Vein Thrombosis ◽  
Low Dose ◽  
Randomized Study ◽  
Hip Surgery ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Deep Vein ◽  
Low Dose Heparin ◽  
Heparin Prophylaxis

Low Molecular Weight Heparin and Prevention of Postoperative Thrombosis in Abdominal Surgery

1992 ◽  
Vol 67 (06) ◽  
pp. 627-630 ◽  
Author(s):  
K Koppenhagen ◽  
J Adolf ◽  
M Matthes ◽  
E Tröster ◽  
J D Roder ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Abdominal Surgery ◽  
Low Molecular Weight Heparin ◽  
Low Dose ◽  
Low Molecular Weight ◽  
Heparin Group ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Deep Vein ◽  
Low Dose Heparin

SummaryIn a prospective, double-blind, randomized multicenter trial the efficacy and safety of low molecular weight heparin and unfractionated heparin were compared for the prevention of postoperative deep vein thrombosis in patients undergoing abdominal surgery. Six hundred and seventy-three patients were randomly allocated to the two prophylaxis groups; 20 of these, however, did not undergo surgery and did not receive any prophylaxis. Of the remaining 653 patients 323 received one subcutaneous injection of 3,000 anti-Xa units of low molecular weight heparin and 330 received subcutaneously 5,000 U heparin three times a day. Treatment was initiated 2 h preoperatively and continued for 7 to 10 days. The occurrence of DVT was determined by the 125I-labelled fibrinogen uptake test and phlebography. Venous thrombosis was diagnosed in 24 of 323 patients (7.4%) treated with low molecular weight heparin and in 26 of 330 patients (7.9%) treated with low-dose heparin. DVT of proximal veins was detected in four patients of the low molecular weight heparin group and in three patients of the low-dose heparin group. During the observation period three pulmonary emboli - one fatal and two non-fatal - occurred in patients receiving prophylaxis with low-dose heparin. No pulmonary embolism was found in patients treated with low molecular weight heparin. Both prophylactic schemes were well tolerated. Intra-and postoperative blood loss, incidence of wound hematoma, frequency and volume of intra- and postoperative blood transfusion were similar in both groups with a slight advantage for the low molecular weight heparin group. The results of this trial show that the investigated low molecular weight heparin is at least as effective and safe as low-dose heparin in preventing deep vein thrombosis in patients undergoing elective abdominal surgery.

scholarly journals Heparin and Venous Thrombo-Embolism

1977 ◽  
Author(s):  
V.V. Kakkar
Keyword(s):  
Pulmonary Embolism ◽  
Low Dose ◽  
Subcutaneous Administration ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Deep Vein ◽  
Kinetics Of ◽  
Low Dose Heparin ◽  
Total Elimination ◽  
Heparin Prophylaxis

Venous thromboembolism represents a serious hazard in patients confined to bed in hospital. Though the search for an effective method of prophylaxis has been going on for nearly the last 90 years, a method which is effective in the total elimination of this condition has yet to be developed. One promising approach is the use of low-dose heparin given subcutaneously.In this review: (a) the rationale for low-dose heparin will be considered in the context of present concepts of pathogenesis of venous thrombosis; (b) factors which govern the kinetics of clearance of heparin from the circulation will be compared following its intravenous and subcutaneous administration; (c) the recently published studies, where the efficacy of this form of prophylaxis against deep vein thrombosis and pulmonary embolism has been assessed, will be analysed, and (d) further possible developments in heparin prophylaxis includingthe use of semi-synthetic heparin analogue will be discussed.

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.

Hepar Inconcentration, Antithrombin III and Antiplasmin in Elective Surgery with Low Dose Heparin Prophylaxis

1979 ◽  
Author(s):  
H.O. Kruse-Blinkenberg ◽  
Johs Gormsen
Keyword(s):  
Low Dose ◽  
Antithrombin Iii ◽  
Elective Surgery ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
At Iii ◽  
Uptake Test ◽  
Deep Vein ◽  
Low Dose Heparin ◽  
Heparin Prophylaxis

Eighty patients underwent abdominal surgery in low dose heparin (Novo) 5.000 units subcutanously 2 hours preoperatively and every 8 hours until full mobilization. Clinical end points were 125J fibrinogen uptake test and venography. Heparin concentrations, antithrombin III(AT III) against IIa and Xa and antiplasmin, were measured on synthetic substrates (Kabi Diagnostica, Sweden). Deep vein thrombosis (DVT) developed in 16 patients. Heparin concentrations were identical in patients ± DVT preoperatively but the concentrations were significantly lower postoperatively on day 1-5 in the patients with DVT, AT III (against IIa)was lower pre- and postoperatively in patients with DVT, but the differences were only significant lower when measuring AT III against Xa, pre- and postoperatively. The antiplasmin level was higher in patients with malignency and in patients with DVT, and the differences were significant postoperatively (p < 0.01).

Low Dose Heparin Versus Oral Anticoagulants in the Prevention of Postoperative Venous Thrombosis in Gynecology

1975 ◽  
Author(s):  
A. E. Schaer ◽  
L. Huber ◽  
P. Bader ◽  
U. Baertschi ◽  
P. Morf
Keyword(s):  
Low Dose ◽  
Oral Anticoagulants ◽  
Randomised Trial ◽  
Postoperative Hemorrhage ◽  
Heparin Group ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Severe Hemorrhage ◽  
Fibrinogen Test ◽  
Low Dose Heparin

In a randomised trial involving 458 patients low dose heparin, peri- and postoperatively given subcutaneousely (Liquemin subcutan Roche) 2 × 5000 U twice daily for one week, was compared with oral anticoagulants. Deep vein thrombosis, diagnosed clinically and by the 125-J-fibrinogen test, was less frequent in the heparin group (2,3%/4,6%). However, the incidence of pulmonary embolism was rather high (6 cases in the heparin group, only one with oral anticoagulants). Mild postoperative hemorrhage occured more often with heparin, but the incidence of severe hemorrhage remained the same (4,5%).These results suggest to examine a combination of the two methods: low dose heparin perioperatively, oral anticoagulants in the postoperative course.

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