PMID- 32617214
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 12
IP  - 5
DP  - 2020 May 28
TI  - Bleeding and Thrombotic Risk in Low Dose Heparin Infusion as Compared to Standard 
      Dose Heparin Infusion.
PG  - e8339
LID - 10.7759/cureus.8339 [doi]
LID - e8339
AB  - Intravenous unfractionated heparin (UFH) remains one of the most commonly used 
      anticoagulants in the hospital setting. The optimal protocol for initiation and 
      maintenance of UFH has been difficult to determine. Over the past two decades, 
      weight-based nomogram protocols have gained favor. Herein, we present a 
      retrospective study of 377 patients at a single tertiary academic center treated 
      with low intensity (LI) and standard intensity (SI) UFH protocols for 
      therapeutic anticoagulation. UFH levels are measured by anti-Xa assay activity 
      with therapeutic levels of 0.30 to 0.70 IU/mL for SI and 0.25 to 0.35 IU/mL for 
      LI.  Patients treated on the LI protocol were more likely to have had a previous 
      history of bleeding and lower baseline hemoglobin. Incidence of new or worsening 
      thrombus while on UFH was comparable between both protocols (odds ratio (OR) 
      0.93, 95% confidence interval (CI) 0.29-2.98, p=0.899). Patients on LI protocol 
      had higher incidence of bleeding while on UFH (OR 1.21, 95% CI 0.51-2.89, 
      p=0.667). Our study thus suggests that the LI protocol may have comparable 
      efficacy to the SI protocol in treating venous thromboembolism (VTE) and that 
      target anti-Xa levels of 0.25 to 0.35 IU/mL may be more optimal in high-risk 
      patients.
CI  - Copyright (c) 2020, Lutfi et al.
FAU - Lutfi, Forat
AU  - Lutfi F
AD  - Hematology and Oncology, University of Maryland Medical Center, Baltimore, USA.
FAU - Bishnoi, Rohit
AU  - Bishnoi R
AD  - Hematology and Oncology, University of Florida Health, Gainesville, USA.
FAU - Patel, Vikas J
AU  - Patel VJ
AD  - Gastroenterology, University of Florida Health, Gainesville, USA.
FAU - Elfasi, Aisha
AU  - Elfasi A
AD  - Neurology, University of Florida Health, Gainesville, USA.
FAU - Setteducato, Michael
AU  - Setteducato M
AD  - Internal Medicine, University of Florida Health, Gainesville, USA.
FAU - Zhang, Shuyao
AU  - Zhang S
AD  - Internal Medicine, University of Texas Southwestern Medical Center, Dallas, USA.
FAU - Shah, Chintan P
AU  - Shah CP
AD  - Hematology and Oncology, University of Florida Health, Gainesville, USA.
FAU - Kurian, Saji
AU  - Kurian S
AD  - Internal Medicine, University of Florida Health, Gainesville, USA.
FAU - Kamath, Chethana
AU  - Kamath C
AD  - Internal Medicine, University of Florida Health, Gainesville, USA.
FAU - Kim, Dae Jun
AU  - Kim DJ
AD  - Internal Medicine, University of Florida Health, Gainesville, USA.
FAU - Zumberg, Marc S
AU  - Zumberg MS
AD  - Hematology and Oncology, University of Florida Health, Gainesville, USA.
FAU - Murphy, Martina
AU  - Murphy M
AD  - Hematology and Oncology, University of Florida Health, Gainesville, USA.
LA  - eng
PT  - Journal Article
DEP - 20200528
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC7325397
OTO - NOTNLM
OT  - anticoagulant therapy
OT  - hemorrhage
OT  - heparin
OT  - thrombosis
OT  - venous thromboembolism
COIS- The authors have declared that no competing interests exist.
EDAT- 2020/07/04 06:00
MHDA- 2020/07/04 06:01
PMCR- 2020/05/28
CRDT- 2020/07/04 06:00
PHST- 2020/07/04 06:00 [entrez]
PHST- 2020/07/04 06:00 [pubmed]
PHST- 2020/07/04 06:01 [medline]
PHST- 2020/05/28 00:00 [pmc-release]
AID - 10.7759/cureus.8339 [doi]
PST - epublish
SO  - Cureus. 2020 May 28;12(5):e8339. doi: 10.7759/cureus.8339.