Treatment goals for deep venous thrombosis include stopping clot propagation and preventing the recurrence of thrombus, the occurrence of pulmonary embolism, and the development of pulmonary hypertension, which can be a complication of multiple recurrent pulmonary emboli. About 30 percent of patients with deep venous thrombosis or pulmonary embolism have a thrombophilia. An extensive evaluation...

Critical care practitioners routinely administer heparin for various indications (e.g., treatment of acute coronary syndrome, venous thromboembolism prophylaxis, line maintenance) and by various routes (e.g., intravenously, subcutaneously). Knowledge of reported incidents involving high-concentration heparin products can increase practitioner awareness of risks for error-induced injury associat...

Heparins are are sulfated polysaccharides that have tremendous clinical importance as anticoagulant drugs. Monitoring of heparin blood levels can improve patient safety. In clinical practice, heparins are monitored indirectly by their inhibtory effect on coagulation proteases. Drawbacks of these established methods have stimulated the development of simple direct detection methods with cationic...

List of abbreviations . . . . . . . . . . . . . . . . . . 2 Preamble: purposes and scope of the task force . . 2 Blood coagulation . . . . . . . . . . . . . . . . . . . . 3 Haemostasis . . . . . . . . . . . . . . . . . . . . . 3 Arterial thrombosis . . . . . . . . . . . . . . . . . 3 Tissue factor . . . . . . . . . . . . . . . . . . . . . 3 Tissue factor pathway inhibitor . . . . . . . . . . 3 ...

AIMS Although hirudin is superior to unfractionated heparin for prevention of death, myocardial infarction, or refractory ischaemia in patients with non-ST-elevation acute coronary syndrome, it is not clear whether hirudin is also of benefit in acute coronary syndrome patients undergoing early percutaneous coronary intervention. METHODS AND RESULTS In the OASIS 2 trial, 10 141 patients with n...

The Seventh American College of Chest Physicians (ACCP) Conference on Antithrombotic and Thrombolytic Therapy provides guidelines for outpatient management of anticoagulation therapy. The ACCP guidelines recommend short-term warfarin therapy, with the goal of maintaining an International Normalized Ratio (INR) of 2.5 +/- 0.5, after major orthopedic surgery. Therapy for venous thromboembolism in...

Heparin and low molecular weight heparins exert their vascular effects by mobilizing tissue factor pathway inhibitor (TFPI) from the vascular endothelium into the blood circulation. We compared the influence of molecular weight on the TFPI release by heparin and its fractions in a non-human primate model. Primates were treated with unfractionated heparin, a low molecular weight heparin (gammapa...

Prophylactic administration of unfractionated heparin is a common practice in a perioperative period. Heparin monitoring with subcutaneous dosing is not recommended; however it becomes important in selected patients. We report a case of massive hemorrhage with subcutaneous heparin administration in an HIV-positive male patient with cachexia and mild liver dysfunction. Prolonged activated plasma...

A ntithrombotic treatment for acute deep vein thrombosis (DVT) or pulmonary embolism (PE) should consist of a therapeutic dose of low molecular weight heparin (LMWH) for o5 days, followed by a vitamin K antagonist for o3 months. LMWH has simplified the initial management of DVT because it is at least as effective and safe as unfractionated heparin and can be administered in fixed subcutaneous d...

There is much interest in in vitro thrombosis systems using exclusively human materials for evaluating new drugs. We have previously developed such a model using a perfusion chamber in which whole blood anticoagulated with low-molecular-weight heparin (LMWH) was circulated over the extracellular matrix of endothelial cells that had been stimulated with phorbol myristate acetate to cause tissue ...