DeXTRAN 70 vs LOW DOSE HEPARIN

For prophylaxis of postoperative pulmonary embolism: multicentre, international study Dextran and low dose heparin are claimed to reduce the incidence of postoperative thromboembolic complications. Recently, a prospective randomised multicentre trial, comparing the prophylactic efficacy of dextran 70 and low dose heparin against fatal pulmonary embolism, was conducted in patients who had just undergone elective operations for general, urological, orthopaedic, and gynaecological conditions. 1993 of such patients received dextran 70 and 1991 received low dose heparin. Three infusions of dextran 70 in normal saline (Macrodex), 500ml, were given; the first was begun soon after induction of anaesthesia, the second after the operation, and the third on the first postoperative day. Subcutaneous sodium heparin 5000iu was given 2 hours preoperatively and 8-hourly thereafter for 6 postoperative days or for the duration of hospital stay if under 7 days. Withdrawal of prophylaxis because of bleeding or technical difficulties occurred more often in the heparin group, but allergic reactions were more common in the dextran group. Of the 75 patients who died within 30 days after operation, 38 had been given dextran and 37 low dose· heparin. Necropsy was performed in 33 and 32 of these cases respectively, but in only 6 patients in each group was pulmonary embolism the sole or contributory cause of death. Thus, there was no statistically significant difference between the 2 treatment groups in the incidence of fatal pulmonary embolism after a full course of prophylaxis. Gruber, V.F. et al: British Medical Journal I: 69 (J 2 Jan 1980)

0156-2703/80/0126-0009 $00.50/0 ©ADIS Press INPHARMA 26 Jan 1980 9