Dextran prophylaxis of fatal pulmonary embolism

Thromboembolic prophylaxis with dextran 70 was given routinely to patients undergoing major surgery from 1970 to 1972 and from 1975 to 1977, using slightly different dosages. During 1968 to 1970 and 1972 to 1974, no routine prophylaxis was given. During the 4 respective 2‐year periods studied, the following number of postoperative fatal pulmonary emboli (FPE) were verified at autopsy: 16 (no prophylaxis); 6 (dextran); 19 (no prophylaxis); and 4 (dextran). The incidence of FPE in relation to major operations was 35/5,094 (0.69%) without prophylaxis, and 10/4,881 (0.20%) with prophylaxis, p < 0.001 . The autopsy rate was 93.4% in postoperative deaths. Adherence to prophylaxis was 88 ± 5%. Routine prophylaxis with dextran 70 during surgery is, therefore, effective against fatal pulmonary embolism. Furthermore, it is easy to perform, lacking many of the practical disadvantages of oral anticoagulants and heparin.