PMID- 25736986
OWN - NLM
STAT- MEDLINE
DCOM- 20160517
LR  - 20181113
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Linking)
VI  - 40
IP  - 3
DP  - 2015 Oct
TI  - High dose subcutaneous unfractionated heparin for prevention of venous 
      thromboembolism in overweight neurocritical care patients.
PG  - 302-7
LID - 10.1007/s11239-015-1202-x [doi]
AB  - Timing and dosing of chemical venous thromboembolism (VTE) prophylaxis in brain 
      injury is controversial. Risk of bleeding while using high dose unfractionated 
      heparin (UFH) in overweight patients to prevent VTE is also unknown. The purpose 
      of this study was to describe the use of subcutaneous heparin 7500 units for VTE 
      prophylaxis in overweight patients. This was a retrospective study comparing 
      patients over 100 kg who received either 7500 units Q8 h (n = 141) (high dose 
      group, HDG), or 5000 units Q8 h (n = 257) (traditional dose group, TDG), of UFH 
      subcutaneously. Both groups had similar rates of bleeding complications. The 
      incidence of drop in hemoglobin by two points in any 24 h was 14 % (20/141) HDG 
      versus 11 % (28/257) TDG; P = 0.33. Hemoglobin drop by two points from baseline 
      was 57 % (81/141) HDG versus 51 % (132/257) TDG; P = 0.24. The need for pRBC 
      transfusion was 26 % (36/141) HDG versus 20 % (52/257) TDG; P = 0.22. An increase 
      in aPTT from baseline by two times was 4 % (5/141) HDG versus 4 % (9/257) TDG, P 
      = 0.59. Discontinuation of heparin therapy for association with progressive 
      bleeding was not documented in any patients. No differences in minor bleeding 
      complications were observed. There was no difference in the incidence of VTE: 5.7 
      % (8/141) HDG versus 9.3 % (24/257) TDG; P = 0.2. In univariate and multivariable 
      logistic regression analysis, only the time of the initiation of heparin after 
      admission was associated with the occurrence of VTE (median, IQR) 46 h (17-86) 
      HDG versus 105 h (56-167) TDG; OR 1.2 (1.1-1.3); P < 0.001. High dose 
      subcutaneous UFH was not associated with an increased risk of bleeding, nor did 
      it decrease the incidence of VTE in overweight patients.
FAU - Samuel, Sophie
AU  - Samuel S
AD  - Department of Pharmacy, Memorial Hermann - Texas Medical Center, 6411 Fannin 
      Street, Houston, TX, 77054, USA, sophie.samuel@memorialhermann.org.
FAU - Iluonakhamhe, Emitseilu K
AU  - Iluonakhamhe EK
FAU - Adair, Eileen
AU  - Adair E
FAU - Macdonald, Natalie
AU  - Macdonald N
FAU - Lee, Kiwon
AU  - Lee K
FAU - Allison, Teresa A
AU  - Allison TA
FAU - Choi, Huimahn A
AU  - Choi HA
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Brain Injuries
MH  - Female
MH  - Heparin/*administration & dosage
MH  - Humans
MH  - Injections, Subcutaneous
MH  - Male
MH  - Middle Aged
MH  - *Overweight
MH  - Retrospective Studies
MH  - Venous Thromboembolism/*prevention & control
EDAT- 2015/03/05 06:00
MHDA- 2016/05/18 06:00
CRDT- 2015/03/05 06:00
PHST- 2015/03/05 06:00 [entrez]
PHST- 2015/03/05 06:00 [pubmed]
PHST- 2016/05/18 06:00 [medline]
AID - 10.1007/s11239-015-1202-x [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2015 Oct;40(3):302-7. doi: 10.1007/s11239-015-1202-x.