Key result
A higher dose of heparin (7500 U twice daily) did not significantly reduce total DVT compared to 5000 U twice daily (22% vs 33%) but significantly reduced extensive DVT after thoracic surgery.
Why the study?
The high incidence of deep venous thrombosis after major thoracic surgery is only partially reduced by routine low-dose heparin prophylaxis, necessitating evaluation of higher doses.
Does heparin 7500 U twice daily reduce scan-detected DVT in patients undergoing thoracotomy for cancer compared to 5000 U twice daily?
Does heparin 7500 U twice daily reduce scan-detected DVT in patients undergoing thoracotomy for cancer compared to 5000 U twice daily?
An increased dose of heparin (7500 U twice daily) safely reduces the extent of postoperative DVT in patients undergoing major thoracic surgery for cancer without increasing bleeding risk.
May reduce extensive but not total DVT after thoracic cancer surgery; hypothesis-generating and requires randomized confirmation before practice change.
The high incidence (50-60%) of deep venous thrombosis of the legs (DVT) after major thoracic surgery is reduced only by about half with routine low-dose heparin prophylaxis. The present study compared the efficacy of a higher dose of heparin (7500 U twice daily) with the commonly used dose of 5000 U twice daily in preventing scan-detected DVT in 100 consecutive patients having thoracotomy for carcinoma of the lung or oesophagus. After the higher dose of heparin, postoperative DVT was not significantly less frequent (22% compared with 33% for total DVT) but was significantly less extensive (8% and 14%, respectively, for bilateral calf DVT, and 0% and 4% for popliteal DVT). Despite prophylaxis, DVT was especially common after oesophagogastrectomy (41% total DVT, 30% extensive DVT). No excessive postoperative bleeding was noted in either group. It is concluded that an increased dose of heparin safely offers increased prophylaxis against DVT in patients undergoing major thoracic surgery for cancer.
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Cade et al. (1983) studied Carcinoma of the lung or oesophagus requiring thoracotomy (n=100). Heparin vs. Heparin 5000 U twice daily was evaluated on Scan-detected total DVT. A higher dose of heparin (7500 U twice daily) did not significantly reduce total DVT compared to 5000 U twice daily (22% vs 33%) but significantly reduced extensive DVT after thoracic surgery.
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