PMID- 21068523
OWN - NLM
STAT- MEDLINE
DCOM- 20101230
LR  - 20181201
IS  - 2154-8331 (Print)
IS  - 2154-8331 (Linking)
VI  - 38
IP  - 4
DP  - 2010 Nov
TI  - Choosing the right heparin prophylaxis strategy in medical patients at risk for 
      developing VTE: an evidence-based approach.
PG  - 18-28
LID - 10.3810/hp.2010.11.336 [doi]
AB  - Many acutely ill medical patients are at significant risk for developing venous 
      thromboembolism (VTE) during hospitalization. Venous thromboembolism risk arises 
      from both the presenting clinical condition as well as predisposing risk factors, 
      such as advanced age. Thromboprophylaxis is underprescribed in these patients. 
      Thrombotic risk assessment could encourage the prescribing of thromboprophylaxis 
      and, therefore, improve patient protection against VTE. Current guidelines from 
      the American College of Chest Physicians and the International Union of Angiology 
      (IUA) recommend thromboprophylaxis with low-dose unfractionated heparin (UFH), a 
      low-molecular-weight heparin (LMWH), or fondaparinux for acutely ill medical 
      patients with VTE risk factors. However, the optimal dose regimen for UFH is 
      unclear. The 2006 evidence-based guidelines from the IUA recommend a 
      3-times-daily dose regimen for UFH. However, UFH is usually administered twice 
      daily despite a lack of evidence for the superiority of this regimen. Both 
      heparin-induced thrombocytopenia and bleeding are associated with UFH, and to a 
      lesser degree with alternative anticoagulants, such as the LMWHs. If utilized, an 
      appropriate prophylaxis regimen in medical patients can reduce the risk of VTE 
      and its burden.
FAU - Harrington, Darrell W
AU  - Harrington DW
AD  - David Geffen School of Medicine, UCLA, Harbor-UCLA Medical Center, Torrance, CA 
      90509, USA. dharrington@ladhs.org
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Hosp Pract (1995)
JT  - Hospital practice (1995)
JID - 101268948
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Polysaccharides)
RN  - 9005-49-6 (Heparin)
RN  - J177FOW5JL (Fondaparinux)
SB  - IM
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Causality
MH  - Drug Administration Schedule
MH  - Drug Prescriptions
MH  - Drug Utilization
MH  - Evidence-Based Medicine/*methods
MH  - Fondaparinux
MH  - Hemorrhage/chemically induced/epidemiology
MH  - Heparin/adverse effects/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Humans
MH  - Incidence
MH  - *Patient Selection
MH  - Polysaccharides/therapeutic use
MH  - Practice Guidelines as Topic
MH  - Practice Patterns, Physicians'
MH  - Risk Assessment/*methods
MH  - Time Factors
MH  - Venous Thromboembolism/epidemiology/etiology/*prevention & control
EDAT- 2010/11/12 06:00
MHDA- 2010/12/31 06:00
CRDT- 2010/11/12 06:00
PHST- 2010/11/12 06:00 [entrez]
PHST- 2010/11/12 06:00 [pubmed]
PHST- 2010/12/31 06:00 [medline]
AID - 10.3810/hp.2010.11.336 [doi]
PST - ppublish
SO  - Hosp Pract (1995). 2010 Nov;38(4):18-28. doi: 10.3810/hp.2010.11.336.