Why the study?
Does unfractionated heparin 5000 U subcutaneously twice daily prevent deep vein thrombosis in medical inpatients compared to placebo or low molecular weight heparin?
Does unfractionated heparin 5000 U subcutaneously twice daily prevent deep vein thrombosis in medical inpatients compared to placebo or low molecular weight heparin?
Unfractionated heparin 5000 U subcutaneously twice daily is less efficacious for DVT prophylaxis in medical inpatients than three times daily dosing or low molecular weight heparins.
UFH 5000 U b.i.d. reduces DVT versus placebo yet remains inferior to t.i.d. or enoxaparin; supports preferring t.i.d. regimens or LMWH in medical inpatients.
A common mode of deep vein thrombosis prophylaxis in medical inpatients is unfractionated heparin 5000 U subcutaneously (s.q.) twice daily. We examined the evidence in favor of using this dose of heparin in this group of patients. MEDLINE was searched for studies using the words deep vein thrombosis prophylaxis and heparin. All randomized controlled trials comparing heparin and placebo or heparin and a low molecular weight heparin were used. Relative risk was 0.4 (95% confidence interval 0.22-0.73) in studies comparing heparin 5000 U s.q. b.i.d. with placebo. Relative risk was 0.28 (95% confidence interval 0.21-0.38) in studies comparing heparin 5000 units s.q. t.i.d. versus placebo. In studies comparing unfractionated heparin with enoxaparin relative risk was 1.42 (95% confidence interval 0.99-2.05). Heparin 5000 U s.q. b.i.d. is less efficacious than low molecular weight heparins and unfractionated heparin 5000 U s.q. t.i.d.
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Yalamanchili et al. (2006) studied this question.
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