PMID- 19558759
OWN - NLM
STAT- MEDLINE
DCOM- 20091021
LR  - 20211020
IS  - 1478-7083 (Electronic)
IS  - 0035-8843 (Print)
IS  - 0035-8843 (Linking)
VI  - 91
IP  - 6
DP  - 2009 Sep
TI  - Audit of anticoagulation after embolectomy for acute ischaemia.
PG  - 470-2
LID - 10.1308/003588409X432329 [doi]
AB  - INTRODUCTION: Intravenous unfractionated heparin (UFH) is routinely used in 
      patients after arterial embolectomy. Achieving and maintaining therapeutic levels 
      requires a co-ordinated approach which may be difficult for busy junior doctors 
      and laboratories. There is no current evidence regarding the use of subcutaneous 
      low molecular weight heparin (LMWH) as an alternative. PATIENTS AND METHODS: The 
      study retrospectively examined all patients who had undergone any form of 
      embolectomy during 2006 and 2007 by review of their medical records, an 
      electronic laboratory database, and the patients' drug charts. RESULTS: Overall, 
      45 patients were studied. A total of 389 activated partial thromboplastin time 
      (APTT) tests were performed of which 146 (37.6%) were in the therapeutic range 
      (50-90 s), 40.4% were < 50 s and 22.1% were > 90 s. Five patients (11.1%) had 
      further surgical procedures. Significant bleeding occurred in two patients. 
      CONCLUSIONS: The results indicate that many patients are not appropriately 
      anticoagulated. Whilst a new UFH protocol is being developed by our hospital 
      trust, the authors believe the use of LMWH could provide a more effective and 
      user-friendly alternative to UFH.
FAU - Robinson, T
AU  - Robinson T
AD  - Department of Vascular Surgery, Oxford Radcliffe NHS Trust, Oxford, UK. 
      tmrobinson@doctors.org.uk
FAU - Hunter, I
AU  - Hunter I
FAU - Wathes, R
AU  - Wathes R
FAU - Keeling, D
AU  - Keeling D
FAU - Hands, L
AU  - Hands L
LA  - eng
PT  - Journal Article
DEP - 20090625
PL  - England
TA  - Ann R Coll Surg Engl
JT  - Annals of the Royal College of Surgeons of England
JID - 7506860
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Acute Disease
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Embolectomy/*methods
MH  - Embolism/*drug therapy
MH  - Hemorrhage/drug therapy
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - Infusions, Subcutaneous
MH  - *Partial Thromboplastin Time
MH  - Retrospective Studies
PMC - PMC2966197
EDAT- 2009/06/30 09:00
MHDA- 2009/10/22 06:00
PMCR- 2010/09/01
CRDT- 2009/06/30 09:00
PHST- 2009/06/30 09:00 [entrez]
PHST- 2009/06/30 09:00 [pubmed]
PHST- 2009/10/22 06:00 [medline]
PHST- 2010/09/01 00:00 [pmc-release]
AID - 10531 [pii]
AID - 10.1308/003588409X432329 [doi]
PST - ppublish
SO  - Ann R Coll Surg Engl. 2009 Sep;91(6):470-2. doi: 10.1308/003588409X432329. Epub 
      2009 Jun 25.