title: Combined administration of dextran 70 and dalteparin does not increase perioperative blood loss compared to dextran 70 alone in major orthopedic surgery.
abstract: A prospective open-labeled clinical study was carried out to compare the safety of dextran 70 and low molecular weight heparin (dalteparin; DD group) versus dextran 70 alone (D group) in patients subjected to elective hip replacement surgery. Dalteparin, 5,000 IU/day and dextran 70, 500 ml during surgery and on the first postoperative day were administered to 214 patients. Dextran 70 alone was infused in 44 patients, 500 ml during surgery and on the 1st, 3rd and 5th postoperative day. Mean total blood loss during the operation and until the 2nd postoperative day was 1,708 ml in the DD group and 1,712 ml in the D group (p = 0.79). During the 1st postoperative week, no group differences were found in the relative number of patients that received packed red blood cells (p = 0.95), the amount of transfused packed red blood cells (p = 1.0) and changes in hemoglobin concentrations (p = 0.69). The present results suggest that dextran 70 and dalteparin can be combined in recommended doses without significantly increasing perioperative bleeding in patients undergoing hip replacement surgery. Bone traumatization and insufficient plugging of surgical traumatized bone surfaces with bone cement favor bleeding. Further well-designed studies are needed to evaluate the safety and efficacy of this regimen.
authors.affiliation: Research Forum, Ullevaal University Hospital, Oslo, Norway.
authors.forename: O E
authors.initials: OE
authors.lastname: Dahl
authors.forename: H K
authors.initials: HK
authors.lastname: Walsoe
authors.forename: T
authors.initials: T
authors.lastname: Aspelin
authors.forename: O
authors.initials: O
authors.lastname: Roise
authors.forename: H
authors.initials: H
authors.lastname: Arnesen
authors.forename: T
authors.initials: T
authors.lastname: Lyberg
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000925:Anticoagulants / Q000008:administration & dosage / Q000494:pharmacology; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001810:Blood Volume; D017985:Dalteparin / Q000008:administration & dosage* / Q000494:pharmacology; D003911:Dextrans / Q000008:administration & dosage* / Q000494:pharmacology; D004359:Drug Therapy, Combination; D017707:Erythrocyte Transfusion; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000494:pharmacology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects*; D010952:Plasma Substitutes / Q000008:administration & dosage; D011446:Prospective Studies
chemical_list: D000925:Anticoagulants; D003911:Dextrans; D005343:Fibrinolytic Agents; D006454:Hemoglobins; D010952:Plasma Substitutes; D017985:Dalteparin