Evaluation of low molecular weight heparin during and after aortic and carotid surgery: dose finding study.
Forty-four patients undergoing abdominal aortic surgery and twenty-eight patients undergoing carotid surgery were randomly treated with different anticoagulant regimens. During surgery, an unfractionated heparin (UFH) intravenous bolus of 50 IU/kg was compared with a low molecular weight heparin (LMWH) bolus of either 120 IU/kg, 80 IU/kg, 40 IU/kg or 20 IU/kg. Six hours after surgery and for 48 hours, an UFH infusion was compared with an LMWH infusion of either 10,000 IU/day or 6,000 IU/day and then, a single LMWH subcutaneous injection of 3,075 IU was administered. Heparin activity was measured by factor Xa inhibitor and by prolongation of APTT which were studied 15, 30 and 60 minutes after cross-clamping, at the end of surgery and six hours later, and on days 1, 2, 3 and 6. After a descriptive analysis of clinical and pharmacokinetic profiles of each regimen, optimal LMWH treatment is proposed.
Alimi
Y S
YS
Department of Vascular Surgery, Hôpital Nord, Chemin des Bourrelly, Marseille, France.
Juhan
C
C
Barthelemy
P
P
Boudier
J L
JL
Pansart
M
M
Boutin
B
B
De Moro
S
S
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001012:Aorta, Abdominal / Q000601:surgery*; D002339:Carotid Arteries / Q000601:surgery*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight