January 1, 1979CRC Critical Reviews in Clinical Laboratory Sciences
Prophylaxis and Therapy of Venous Thromboembolism
Why the study?
Does heparin prophylaxis and therapy reduce venous thromboembolism in hospitalized patients?
Population
Hospitalized patients at high risk for venous thromboembolism, including those undergoing general…
Comparison
Heparin vs Intermittent i.v. heparin
Design
Review
Authors
Discussion
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Implication
Supports targeted low-dose s.c. heparin prophylaxis in general surgery; leaves open optimal regimens for hip surgery and continuous versus intermittent IV dosing.
Key Points
- To evaluate the effectiveness and safety of heparin for the prophylaxis and treatment of venous thromboembolism.
- Utilized low-dose heparin (5000 units, s.c. every 8 hours) in patients after general abdominothoracic surgery for prophylaxis.
- Compared continuous vs. intermittent intravenous administration in therapeutic settings.
- Monitored complications and recurrence rates in various surgical populations.
- Low-dose heparin effectively reduced nonfatal and fatal pulmonary embolism in certain surgical patients.
- Hemorrhagic complications occurred in up to 30% of patients receiving large doses but were less frequent with continuous i.v. administration.
- Recurrent venous thromboembolism rates were low with therapeutic heparin, showing no difference between continuous and intermittent i.v. dosing.
Structured PICO
Does heparin prophylaxis and therapy reduce venous thromboembolism in hospitalized patients?
P
Population
Hospitalized patients at high risk for venous thromboembolism, including those undergoing general abdominothoracic surgery, hip surgery, and suprapubic prostatectomy, as well as patients with established thrombosis.
I
Intervention
Heparin (low-dose 5000 units 8 hourly s.c. for prophylaxis; large doses continuous or intermittent i.v. for treatment)
C
Comparator
Intermittent i.v. heparin (for the treatment comparison)
O
Outcome
Venous thrombosis, nonfatal and fatal pulmonary embolism, and hemorrhagic complicationshard clinical
Low-dose heparin is effective for VTE prophylaxis in general surgery but less so in high-risk orthopedic/urologic surgeries, while continuous IV heparin is safer than intermittent IV for VTE treatment.
Cite This Study
Turpie et al. (1979) studied this question.