Document Detail


Preoperative use of enoxaparin is not a risk factor for postoperative bleeding after coronary artery bypass surgery.
MedLine Citation:
PMID:  14688699     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to determine whether the use of low-molecular-weight heparin before coronary artery bypass surgery would be associated with an increase in bleeding and use of blood products after the operation. METHODS: Sixty-four patients (48 men and 16 women) aged 64 +/- 10 years who were undergoing primary coronary artery bypass surgery were prospectively studied. Forty-one patients were treated with either subcutaneous enoxaparin 1 mg/kg twice daily (n = 21; enoxaparin group) or intravenous heparin (n = 20; heparin group). Patients received the last dose of enoxaparin 8.7 +/- 0.75 hours (range, 8-10 hours) before skin incision. Heparin was stopped before transfer to the operating room. An additional 23 consecutive patients who received neither enoxaparin nor heparin served as controls (n = 23). Anti-factor Xa activity, a measure of enoxaparin and heparin activity, was measured at the start of the operation in all patients. RESULTS: There was no perioperative mortality. The length of stay and frequency of postoperative complications were similar between groups. Preoperative anti-factor Xa activity was present only in the enoxaparin group (0.43 +/- 0.25 IU/mL). Chest tube drainage at 24 hours was 553 +/- 160 mL, 532 +/- 140 mL, and 587 +/- 230 mL for the enoxaparin, heparin, and control groups, respectively (P =.48). There was no difference among groups in the amount of blood products transfused. CONCLUSIONS: Enoxaparin administration more than 8 hours before coronary artery bypass surgery is not associated with increased postoperative bleeding or blood product transfusion.
Authors:
Benjamin Medalion; George Frenkel; Paulina Patachenko; Eli Hauptman; Lior Sasson; Arie Schachner
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  126     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-22     Completed Date:  2004-01-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1875-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiothoracic Surgery, The Edith Wolfson Medical Center, Holon, Israel. medalion@wolfson.health.gov.il
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MeSH Terms
Descriptor/Qualifier:
Aged
Anticoagulants / administration & dosage,  adverse effects*
Blood Transfusion
Coronary Artery Bypass*
Enoxaparin / administration & dosage,  adverse effects*
Female
Heparin / administration & dosage
Humans
Injections, Intravenous
Injections, Subcutaneous
Length of Stay
Male
Middle Aged
Postoperative Complications
Postoperative Hemorrhage / chemically induced*,  therapy
Preoperative Care
Prospective Studies
Risk Factors
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Enoxaparin; 9005-49-6/Heparin
Comments/Corrections
Comment In:
J Thorac Cardiovasc Surg. 2004 Aug;128(2):327-8   [PMID:  15282477 ]

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


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