Administración de heparinas de bajo peso molecular y aparición de hematoma

Manrique, Gabriel Aguilera; Gámez, Genoveva Granados; Paris, Matthieu; Anrique, Francisco Aguileram; Cáceres, Esther Del Rocío García; García, Marcos

doi:10.1016/s1130-8621(02)73735-2

Cited by 6 publications

(6 citation statements)

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“…Thus, every time that the SF increases by 1 mm, the risk of developing HMTs increases by 4%. Like this study, Aguilera et al [ 7 ] in their study with two obese groups (SF > 40 mm), found that not grabbing the abdominal pinch to administer the LMWH was positively correlated with the non-appearance of HMTs. This might suggest that the standard procedure for the administration of LMWH (with pinch) increases the appearance of HMTs in obese people, in line with our results.…”

Section: Discussionsupporting

confidence: 51%

“…LMWH has several secondary effects. A multitude of studies [ 4 , 5 , 6 , 7 , 8 , 9 ] reported this and searched for modifications to the administration technique to reduce or eliminate these effects. This suggests that these effects may be the sum of two factors: the effect of the drug and the administration technique used by the healthcare professional.…”

Section: Introductionmentioning

confidence: 99%

“…Different authors [ 4 , 5 , 6 , 7 , 8 , 9 ] carried out studies modifying variables involved in the administration technique to find modifications that might reduce pain, itch, and local HMTs. Among the variables tested in these studies are age, gender, pathology, type of LMWH, disinfect the area before injection, interior diameter and length of the needle, area selected for the injection, method of holding the skin (fold) during the injection, time or speed of injection, mode of extraction, pressure on the injection area afterwards, cleaning technique after injection, and monitoring.…”

Section: Introductionmentioning

confidence: 99%

“…The literature [ 4 , 5 , 6 , 7 , 8 , 9 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ] shows high incidence of HTMs, of up to 88.9% [ 15 ]. Several authors included anthropometric variables in their studies, relating these to the appearance of HMTs, and showing that obese participants had a higher rate of HMTs [ 7 , 8 , 14 ], also finding a positive correlation between the non-appearance of HMTs and the elimination of HMTs of the pinch (skin fold formation) before injecting the obese participant [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Focusing on local reactions in the injection area, the aforementioned file reports an incidence of 0.1-1% for moderate local irritation, pain, bruising, and ecchymosis and, on rare occasions, hard lumps (0.01-0.1%). However, the literature from the perspective of nursing care and focused on the drug administration procedure [4][5][6][7][8][9][10][11] reports a higher incidence of local lesions in the injection area and contradicts previous data. Local haematomas (HMTs) can occur at a rate of 40-88% [4,12], depending on the variables modified in the administration procedure.…”

Section: Introductionmentioning

confidence: 99%

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Obesity as a Risk Factor in the Appearance of Haematomas Caused by Low-Molecular-Weight Heparin: A Cross-Sectional Study

Díaz-González

2023

Nursing Reports

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Thromboembolic disease (TED) is an important health problem in Europe due to its high morbimortality. Pharmacological prevention is achieved with low-molecular-weight heparin (LMWH), among other strategies, which are supported by a high degree of evidence in the scientific literature. According to its safety data sheet, this injection produces local injuries at a rate of 0.1–1% after administration; however, these percentages are much lower than others reported in several studies focusing on LMWH (44–88%). This high incidence of injuries might be associated with procedural or individual variables. (1) Background: Among the most frequent side effects after the administration of LMWH are pain and haematomas (HMTs), which are influenced by obesity. We aimed to determine the relationship between abdominal skinfold (ASF) value and incidence of HMTs. In addition, I sought to determine how the risk of HMT changed with each mm increase in ASF. (2) Methods: A cross-sectional descriptive study developed in the hospital unit of orthopaedic and trauma surgery was conducted over one year. All participants in the sample were classified based on their ASF and the appearance and area of HMTs were assessed after the administration of enoxaparin. The STROBE checklist was used to evaluate the study. Descriptive statistical analysis and analysis of variance of non-parametric factors were carried out. (3) Results: In a sample of 202 participants (808 Clexane injections), more than 80% presented HMTs. More than 70% of the sample was overweight and more than 50% had an ASF > 36 millimetres (mm). (4) Conclusions: An ASF over 36 mm confers a higher risk of developing HMTs: with each mm increase in the ASF, the risk increases by 4%. Participants who are overweight or obese also present a higher risk of HMT, and these conditions correlate positively with the area of the HMTs. Providing education for the self-administration of the drug after discharge and information about the probability of suffering from local injuries in a more individualised way will lead to fewer primary care nursing consultations, more adherence to the antithrombotic treatment, and, as a consequence, a decrease in TED and health costs.

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Section: Discussionsupporting

confidence: 51%