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April 19, 1975BMJOpen Access

Dextran 70 in prophylaxis of thromboembolic disease after surgery: a clinically oriented randomized double-blind trial.

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Why the study?

Does dextran 70 administered by intravenous drip during operation prevent pulmonary embolism in patients over 40 years of age undergoing elective abdominal surgery?

Population

831 patients over 40 years of age who underwent elective surgery of the stomach, biliary system, or colon

Comparison

Dextran 70 administered by intravenous drip… vs Normal saline before the operation

Design

RCT, randomized, double-blind

Authors

AKAlex J. KlineAtrium Health Wake Forest BaptistLHL E HughesUniversity of South WalesHCH. CampbellQueen's University Belfast

Discussion

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Implication

Supports dextran 70 in elective abdominal surgery over age 40; confirms benefit for pulmonary embolism prevention in this RCT.

Key Points

  • To evaluate the efficacy and safety of intravenous dextran 70 compared to saline in preventing postoperative thromboembolic complications and mortality following elective surgery.
  • Randomized double-blind trial conducted in 831 patients aged over 40 undergoing elective surgery of the stomach, biliary system, or colon.
  • Patients received either an intravenous infusion of dextran 70 (n=396) or normal saline control (n=435) before and during the operation.
  • Outcomes were monitored clinically for pulmonary embolism, overall mortality, and deep vein thrombosis detected by clinical examination or 125I-fibrinogen scanning.
  • Pulmonary embolism developed in 3 of 396 patients (0.8%) in the dextran group compared with 13 of 435 patients (3.0%) in the saline group.
  • Fatal pulmonary embolism caused 1 death in the dextran group compared with 7 deaths in the saline group.
  • Deep vein thrombosis incidence was similar between both study arms, and dextran 70 did not lead to a statistically significant increase in excessive bleeding.

Structured PICO

Does dextran 70 administered by intravenous drip during operation prevent pulmonary embolism in patients over 40 years of age undergoing elective abdominal surgery?

P
Population
831 patients over 40 years of age who underwent elective surgery of the stomach, biliary system, or colon
I
Intervention
Dextran 70 administered by intravenous drip during operation
C
Comparator
Normal saline before the operation
O
Outcome
Pulmonary embolismhard clinical

Intravenous dextran 70 during elective abdominal surgery is effective in preventing pulmonary embolism and reducing related mortality without significantly increasing excessive bleeding.

Cite This Study

Kline et al. (1975) studied this question.

synapsesocial.com/papers/6a702cace36a167817e1eb01https://doi.org/10.1136/bmj.2.5963.109

Topics

Pulmonary embolism
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Small Subcutaneous Doses of Heparin in Prevention of Venous Thrombosis1973 · 426 citations
  2. 2The Diagnosis of Deep Vein Thrombosis Using the 125I Fibrinogen Test1972 · 265 citations
  3. 3125I-labelled fibrinogen in the diagnosis of deep-vein thrombosis and its correlation with phlebography1968 · 309 citations