Prevention of Venous Thromboembolism in the Cancer Surgical Patient

2009 ◽  
Vol 27 (29) ◽  
pp. 4881-4884 ◽  
Author(s):  
Ajay K. Kakkar
Keyword(s):  
Venous Thromboembolism ◽  
Malignant Disease ◽  
Low Dose ◽  
Thromboembolic Disease ◽  
Surgical Patients ◽  
Surgical Patient ◽  
Low Molecular Weight ◽  
Common Complication ◽  
Thromboembolic Complications ◽  
High Risk Populations

Venous thromboembolism is a common complication in patients with malignant disease. One of the environments in which patients can present with symptomatic thromboembolic disease is in the postoperative period. Operation in the patient with cancer increases the risk of thromboembolic complications some two to three fold. A variety of methods have been evaluated for the prevention of thromboembolic disease in cancer surgical patients. The most extensively investigated are the pharmacologic methods, including low-dose unfractionated heparin and low molecular weight heparin. These agents are recommended for the prevention of thromboembolic disease during hospital stay. For selected high-risk populations, extended thromboprophylaxis into the postdischarge period is also recommended.

A Comparison of Low-Dose Heparin with Low-Molecular-Weight Heparin as Prophylaxis against Venous Thromboembolism after Major Trauma

1996 ◽  
Vol 335 (10) ◽  
pp. 701-707 ◽  
Author(s):  
William H. Geerts ◽  
Richard M. Jay ◽  
Karen I. Code ◽  
Erluo Chen ◽  
John Paul Szalai ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Venous Thromboembolism ◽  
Low Molecular Weight Heparin ◽  
Major Trauma ◽  
Low Dose ◽  
Low Molecular Weight ◽  
Dose Heparin ◽  
Low Dose Heparin

Does Low-dose Droperidol Increase the Risk of Polymorphic Ventricular Tachycardia or Death in the Surgical Patient?

2013 ◽  
Vol 118 (2) ◽  
pp. 382-386 ◽  
Author(s):  
Gregory A. Nuttall ◽  
Ann M. Malone ◽  
Carrie A. Michels ◽  
Laurie C. Trudell ◽  
Tricia D. Renk ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Low Dose ◽  
Torsade De Pointes ◽  
Postoperative Nausea And Vomiting ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Primary Objective ◽  
Surgical Patients ◽  
Polymorphic Ventricular Tachycardia ◽  
Direct Result ◽  
Surgical Patient

Abstract Background: The Food and Drug Administration issued a black box warning regarding the use of droperidol and the potential for torsade de pointes. Methods: The primary objective of this retrospective study was to determine if low-dose (0.625 mg) droperidol administration was associated with episodes of torsade de pointes in the general surgical population during the 3-yr period following the reinstitution of droperidol to our institutional formulary. Results: The authors identified 20,122 surgical patients who received 35,536 doses of droperidol. These patients were cross-matched with an electrocardiogram database and an adverse outcome database. The charts of 858 patients were reviewed, including patients with documentation of prolonged QTc (>440 ms) from March 2007 to February 2011, polymorphic ventricular tachycardia (VT) within 48 h of receiving droperidol, or death within 7 days of receiving droperidol. Twelve surgical patients had VT (n = 4) or death (n = 8) documented within 48 h of droperidol administration. No patients developed polymorphic VT or death due to droperidol administration (n = 0). The eight patients that died were on palliative care. The four patients with documented VT had previous cardiac conditions: two had pre-existing implantable cardiac defibrillators, three had episodes of VT before receiving droperidol, and another had pre-existing hypertrophic obstructive cardiomyopathy. The authors found 523 patients with a documented QTc >440 ms before receiving droperidol. No patients developed VT or death as a direct result of droperidol administration. Conclusions: Our evidence suggests that low-dose droperidol does not increase the incidence of polymorphic VT or death when used to treat postoperative nausea and vomiting in the surgical population.

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