Key result
Massive IV heparin extends clotting times beyond 1 hour in acute thromboembolism without bleeding.
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Reports clinical observations on massive heparin dosing in acute thromboembolic disease, highlighting high drug tolerance without bleeding complications.
To the Editor:— Dr. Gurewich and his associates can only be applauded for the emphasis on massive heparinization in acute thromboembolic disease ( 199 :116, 1967). Intermittent intravenous administration of heparin in 100- to 150-mg doses, four to six times a day in the acute phase of thromboembolism, has been employed by us since 1941 ( JAMA 142 :527, 1950, and the fact that the patient's response to heparin fluctuates from resistance to sensitivity was demonstrated in 1943 by a simple in vivo heparin tolerance test ( Surg Gynec Obstet 77 :39, 1943). I would strongly differ, however, with their recommendation for the maintenance of two to three times normal control value for the continued treatment of thromboembolism. In my experience, the initial massive doses of 60,000 to 100.000 units a day lead often to clotting times well exceeding one hour without any evidence of bleeding. However, the dosage of heparin has to
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G. De Takats (1967) conducted a letter in Acute thromboembolic disease. Intermittent intravenous heparin was evaluated. Massive initial intravenous heparin (60,000-100,000 units/day) in acute thromboembolism often extends clotting times beyond 1 hour without bleeding.
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