Heparin, deep venous thrombosis, and trauma patients

Article Abstract:

Patients who suffer multiple traumatic injuries are often critically ill. In addition to their most obvious injuries, there is also the possibility of undetected injuries; one of these is deep venous thrombosis, an abnormal condition in which clotting elements and cell debris accumulate and attach to a point on the interior wall of one of the many systemic veins that accompany the arteries. A blood clot may become free of the vessel wall and travel in the blood stream only to become lodged in another vessel, causing obstruction. The actual incidence of deep venous thrombosis in trauma patients is not known, although young active patients should have a low risk. A 7 percent incidence has been reported in high-risk trauma patients. Prevention of deep venous thrombosis is an essential part of treatment of the trauma patient. The incidence of deep venous thrombosis is significantly reduced for general surgery patients who are given a minidose of the anticoagulant drug heparin as prevention. A study was undertaken of 100 trauma patients to determine the usefulness of prophylactic heparin in prevention of deep venous thrombosis. All patients were severely injured. Most patients (96 percent) had suffered blunt trauma as a result of car or motorcycle accidents or falls. Patients were monitored initially and at specific intervals for the development of deep venous thrombosis. Fifty patients received heparin (5,000 units) prophylactically and 50 did not. Fifteen patients developed deep venous thrombosis; 14 of these had received prophylactic heparin. The incidence of deep venous thrombosis was 28 percent in the heparin group and 2 percent in the group receiving no prophylaxis. It is concluded that use of heparin at this dosage level provided no protection to trauma patients, and in fact may have been worse than no heparin at all. Patients with increased risk of deep venous thrombosis might be given either increased doses of heparin or treated with a different method of prophylaxis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Complications and side effects, Blunt trauma, Traumatology

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Heparin prophylaxis for medical patients?

Article Abstract:

More research is needed to determine if all hospital patients should receive heparin to prevent deep vein thrombosis and pulmonary embolism. These conditions are caused by blood clots in the leg veins and lungs, respectively. Pulmonary embolism can be fatal and can be prevented by anticoagulants such as heparin. However, an overview of several studies reveals that the reduction in mortality from heparin use in hospital patients may be small. Patients with risk factors such as heart attack and stroke may benefit but even this evidence is not conclusive.

Care and treatment, Editorial, Usage, Pulmonary embolism, Hospital patients

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Low-molecular-weight heparin given for several weeks after hip surgery prevents deep venous thrombosis

Article Abstract:

Giving hip surgery patients low-molecular-weight heparin for 4 to 6 weeks can substantially lower their risk of deep vein thrombosis. Deep vein thrombosis occurs when a blood clot forms in the large veins of the legs. It is dangerous because the clot can break off and travel to other parts of the body.

Surgery, Postoperative complications, Hip, Complications

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