Document Detail


Low-molecular-weight heparin and unfractionated heparin in prophylaxis against deep vein thrombosis in critically ill patients undergoing major surgery.
MedLine Citation:
PMID:  19844176     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of the present study was to compare the efficacy and safety of low-dose unfractionated heparin (UFH) and a low-molecular-weight heparin (LMWH) as prophylaxis against venous thromboembolism in critically ill surgical patients undergoing major surgery. This was a randomized prospective study in which critically ill patients scheduled to undergo major elective surgery were allocated to receive subcutaneously either LMWH once daily and a placebo injection containing sterile 0.9% normal saline or 5000 IU UFH twice daily subcutaneously. Each patient was evaluated postoperatively clinically and confirmed by Doppler study for development of deep vein thrombosis (DVT). One hundred and fifty-six patients completed the protocol. There was similar efficacy of UFH as compared with LMWH in the prophylaxis of DVT. There was also no statistically significant difference in the incidence of major complications in the heparin group as compared with the LMWH group. However, minor hemorrhagic complications such as wound hematoma and surgical site bleeding were significantly more in the heparin group as compared with the LMWH group. Both UFH 5000 units subcutaneously twice daily and LMWH 40 mg once daily provide highly effective and well tolerated prophylaxis for critically ill surgical patients. Considering the advantage of once-daily dosing, a wider adoption of prophylaxis with LMWH may be justified on the basis of patient acceptability and saving of nursing time.
Authors:
Anushtup De; Prabal Roy; Vinod K Garg; Narendra K Pandey
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis     Volume:  21     ISSN:  1473-5733     ISO Abbreviation:  Blood Coagul. Fibrinolysis     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-12     Completed Date:  2010-03-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102551     Medline TA:  Blood Coagul Fibrinolysis     Country:  England    
Other Details:
Languages:  eng     Pagination:  57-61     Citation Subset:  IM    
Affiliation:
General and Minimally Invasive Surgery, Fortis Escorts Hospital and Research Centre, Haryana, India. anustupdey@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anticoagulants / administration & dosage,  adverse effects,  therapeutic use*
Critical Illness*
Drug Administration Schedule
Enoxaparin / administration & dosage,  adverse effects,  therapeutic use*
Female
Follow-Up Studies
Hemorrhage / chemically induced,  epidemiology
Heparin / administration & dosage,  adverse effects,  therapeutic use*
Humans
Injections, Subcutaneous
Male
Middle Aged
Postoperative Complications / chemically induced,  epidemiology,  prevention & control*,  ultrasonography
Premedication*
Prospective Studies
Risk Factors
Surgical Procedures, Elective*
Venous Thrombosis / prevention & control*,  ultrasonography
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Enoxaparin; 9005-49-6/Heparin

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


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