Document Detail


Efficacy and safety of danaparoid sodium (ORG 10172) in critically ill patients with heparin-associated thrombocytopenia.
MedLine Citation:
PMID:  10378558     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the effectiveness and the safety of danaparoid sodium in the treatment of critically ill patients with standard unfractionated heparin-induced thrombocytopenia (HIT) or low-molecular-weight HIT. SETTING: University hospital. PATIENTS AND METHODS: Retrospective analysis of 42 consecutive critically ill patients who were admitted for HIT between October 1992 and February 1997 and were treated either with therapeutic or prophylactic doses of danaparoid sodium. RESULTS: Among the 26 patients treated with therapeutic doses, neither new thrombotic complications nor thrombosis extension was clinically suspected. Two deaths were directly related to lower limb acute arterial thrombosis associated with HIT. Two major hemorrhagic complications were observed when aspirin in addition to danaparoid sodium was administered. When danaparoid sodium was used in prophylactic doses (20 courses of treatment) to prevent either postsurgical or medical thrombotic complications, no thrombotic event was observed. No death related to HIT or danaparoid sodium treatment was observed. One aggravation of a postsurgical cerebral lesion was observed. During danaparoid sodium treatment, a persistence or a recurrence of thrombocytopenia was observed in 6.5% of patients without thrombotic complications. CONCLUSION: Danaparoid sodium appears to be an efficient and safe treatment in critically ill patients with HIT. The concomitant use of aspirin in addition to danaparoid sodium seems to represent an important additional hemorrhagic risk that should be avoided in patient management.
Authors:
B Tardy-Poncet; B Tardy; J Reynaud; P Mahul; P Mismetti; E Mazet; D Guyotat
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Chest     Volume:  115     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-07-08     Completed Date:  1999-07-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1616-20     Citation Subset:  AIM; IM    
Affiliation:
Department of Hematology, Hopital Nord CHRU, Saint-Etienne, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anticoagulants / adverse effects*
Aspirin / therapeutic use
Blood Coagulation Factors / metabolism
Chondroitin Sulfates / administration & dosage,  therapeutic use*
Critical Illness
Dermatan Sulfate / administration & dosage,  therapeutic use*
Drug Therapy, Combination
Female
Fibrinolytic Agents / administration & dosage,  therapeutic use*
Follow-Up Studies
Heparin / adverse effects*
Heparitin Sulfate / administration & dosage,  therapeutic use*
Humans
Injections, Subcutaneous
Male
Middle Aged
Platelet Aggregation Inhibitors / therapeutic use
Platelet Count
Recurrence
Retrospective Studies
Safety
Thrombocytopenia / blood,  chemically induced,  drug therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Blood Coagulation Factors; 0/Fibrinolytic Agents; 0/Platelet Aggregation Inhibitors; 24967-94-0/Dermatan Sulfate; 50-78-2/Aspirin; 83513-48-8/danaproid; 9005-49-6/Heparin; 9007-28-7/Chondroitin Sulfates; 9050-30-0/Heparitin Sulfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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