Does low-dose heparin prophylaxis reduce the incidence of deep venous thrombosis in critically ill patients?
Low-dose subcutaneous heparin prophylaxis effectively reduces the incidence of deep venous thrombosis in critically ill patients.
The incidence of deep venous thrombosis of the legs (DVT) was studied in 119 critically ill patients by 125I-labeled fibrinogen scanning; the efficacy of low-dose heparin prophylaxis was assessed in a randomized, double-blind study. DVT occurred in 29% of control patients and in 13% of patients receiving heparin 5000 U subcutaneously twice daily. DVT was found mainly in men and was associated with circulatory impairment, respiratory failure and recent vascular or cancer surgery. In a comparison study of medical patients, DVT occurred in 10% untreated and 2% treated. In conclusion, the critically ill are at high risk of venous thromboembolism and low-dose prophylaxis is warranted in those who have no hemostatic impairment.
J. F. Cade (1982) studied this question.