Weight-based heparin dosing is more effective in the treatment of postoperative deep vein thrombosis.
Rapid clinical diagnosis and adequate treatment are the major determinants of successful therapy of deep vein thrombosis (DVT). In the initial treatment of DVT, heparin is the anticoagulant of choice. Appropriate heparin dosing is of major interest concerning the onset of therapeutic anticoagulation and, thus, the clinical outcome of the patients. This study was designed to compare a weight-based heparin nomogram with a standard heparin nomogram for the treatment of DVT in orthopaedic patients. Forty patients in two groups were included in the study. In group one (patients treated with the weight-based heparin nomogram) the therapeutic range (partial thromboplastin time 1.5-2.3 times the control) was reached on average within 24 h (75% of the patients); 95% of the patients reached the therapeutic range within 48 h. In group two (patients treated with the standard heparin nomogram) the therapeutic range was reached on average within 48 h (60%; 30% of the patients reached the therapeutic range within 24 h). The used weight-based heparin nomogram has proved to be effective, safe and superior to one based on standard practice concerning the time elapsed between initial heparin therapy and achieving the therapeutic range for intravenous anticoagulation.
Städtische Kliniken Dortmund, Klinik für Orthopädie, Germany.
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Katthagen
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D001699:Biometry; D001835:Body Weight; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D011183:Postoperative Complications / Q000188:drug therapy*; D011446:Prospective Studies; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000188:drug therapy*
D000925:Anticoagulants; D006493:Heparin