Why the study?
Does postoperative thrombosis prophylaxis with dextran and warfarin alter haemostatic parameters and ESR in vascular surgical patients?
Does postoperative thrombosis prophylaxis with dextran and warfarin alter haemostatic parameters and ESR in vascular surgical patients?
Dextran combined with warfarin for postoperative thrombosis prophylaxis in vascular surgery increases ESR but does not interfere with Thrombotest monitoring or increase bleeding risk if TT > 7%.
No excess bleeding seen with TT >7% during dextran-warfarin prophylaxis; leaves open ESR's utility for monitoring in vascular surgery.
Haematological tests and parameters of coagulation and fibrinolysis were studied in 13 patients given postoperative thrombosis prophylaxis with dextran 70 (Macrodex) or dextran 40 (Rheomacrodex), combined with warfarin. The same parameters were examined in a control group of 20 patients. Dextrans, in particular dextran 70, induced an increase of the erythrocyte sedimentation rate (ESR) which by far exceeded the normal postoperative ESR-elevation. Hyperfibrinogenaemia, which is probably the main cause of the usual postoperative ESR-increase, was far less pronounced, or absent, in the dextran-treated patients. The extent of fibrinogen consumption and fibrinolysis seemed to be uninfluenced by the dextran treatment. An accumulation of high molecular weight fractions of dextran in serum occurred during the treatment, and this is probably the main cause of the altered ESR-respcnse. The dextran treatment did not introduce errors in the control of anticoagulant therapy with Thrombotest (TT). Bleeding was not induced by the combined prophylaxis with dextran and warfarin, provided the TT-values were above 7%.
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Rø et al. (1974) studied this question.
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