ULTRA-lOW DOSE IV HEPARIN PREVENTS DEEP VEIN THROMBOSIS

In a double-blind, randomized trial, 95 patients were given either ultra-low dose heparin (I iU/kg/hour) or a saline control by continuous IV infusion for 3-5 days d\lring and after surgery. Deep vein thrombosis and pulmonary embolism were observed in 22 % (II/50) of the saline recipients, while these occurred in only 4 %(2/45) of the heparin patients. Small wound hematomas appeared in 2 patients on heparin, and in I on saline. There were no significant differences in blood transfusion requirements or in postoperative hemorrhage between the 2 groups. Negus, D, et al.: Lancet I: 891 (26 Apr 1980)

... without causing antithrombin III depletion The above work raises the intriguing prospect of preventing deep vein thrombosis by doses once considered homeopathic. As a liu/kg/hour dose theoretically produces a heparin plasma level ofO.007iu/ ml, it is unlikely to reduce circulating antithrombin III. Thus, hypocoagulability that may contribute to bothersome bleeding could be avoided. The dose is enough to release lipoprotein lipase and possibly endothelial anti thrombotic material, and to reduce a postoperative increase in platelet adhesiveness Which would have led to platelet-fibrin thrombosis formation. A large scale study is now needed to investigate the incidence of postoperative wound hematomas after ultra-low dose IV heparin, as compared to that given subcutaneously. Editorial: Lancet I: 907 (26 Apr 1980)

12 INPHARMA 24 May 1980 0156-2703/80/0524-0012 $00.50/0 © ADIS Press