Heparin Therapy in Thromboembolic Disease

Kernohan, R. J.; Todd, Charles

doi:10.1016/s0140-6736(66)90822-1

Cited by 115 publications

(23 citation statements)

References 10 publications

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“…13 Anticoagulation is indicated in patients with thrombosis or embolism unless contraindications to therapy are compelling, but the methods of anticoagulation and monitoring are controver¬ sial.…”

mentioning

confidence: 99%

Physician Practices in the Treatment of Pulmonary Embolism and Deep Venous Thrombosis

1988

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mentioning

confidence: 99%

Physician Practices in the Treatment of Pulmonary Embolism and Deep Venous Thrombosis

1988

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“…In 1960, Barritt et al reported that heparin anticoagulation significantly reduced mortality of APTE patients. 3 Subsequent studies have attested to the reduced mortality rate when heparin anticoagulation was used to treat venous thromboembolic disease 16,17 and to the high mortality when APTE patients did not receive anticoagulant therapy. 18 Our results were consistent with those reports.…”

Section: Discussionmentioning

confidence: 99%

Association Between Antithrombotic Treatments and Prognosis of Patients With Acute Pulmonary Thromboembolism in Japan

Ota

Nakamura

Yamada

et al. 2003

Circ J

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“…Even accepting that without the use of a constant infusion device the rate of delivery of heparin given by gravity drip infusion will vary, it should be possible to ensure continuous action throughout the 24 hours and to monitor the effect by laboratory tests. Amongst the authors who have used the constant infusion method there are wide variations in recommended dosage schedules from 20,000 to 120,000 units daily (Kernohan and Todd, 1966;Gurevich, Thomas, and Stuart, 1967). The continuous intravenous therapy lends itself to the measurement of heparin effect which can later be correlated with clinical effect, and such a step seems necessary if these different opinions are to be reconciled.…”

Section: Discussionmentioning

confidence: 99%

Laboratory control of heparin therapy

O’Shea¹,

Flute²,

Pannell³

1971

J Clin Pathol

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SYNOPSISThe effect of heparin therapy was followed in 50 patients treated for thrombo-embolic disease. Individual response to a standard dose of 40,000 units of heparin daily showed a considerable variation and the effect was not constant on subsequent days. Five of the 50 patients developed a serious haemorrhage.It is proposed that to ensure the adequacy of treatment detectable levels of heparin should be obtained but because of the high risk of bleeding these levels should not be excessive.The results suggest that control of heparin therapy can be based on the thrombin clotting time. Using this test it is advised that treatment is monitored daily in order to achieve a plasma heparin level of up to 1 mg per 100 ml. Classical laboratory control is with the whole blood clotting time. It is often said that this should be prolonged to between one and a half and three and a half times the normal value for the individual. On intermittent intravenous injection the test should be taken just before the next dose is due. It is not clear whether the same criteria should be used for continuous heparin infusion. The clotting time is imprecise, difficult to standardize, and if any degree of accuracy is to be obtained the test must be performed at the bedside and at 37°C. Few will be content to wait the long time till the endpoint is reached. Since heparin inhibits the action of thrombin many of the standard clotting tests should be affected. Some of these were first examined for their sensitivity to the effect of heparin added to normal plasma. Blood from a series of 50 patients who were receiving heparin infusions was then examined to test these laboratory findings in practice.

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Heparin Therapy in Thromboembolic Disease

Cited by 115 publications

References 10 publications

Physician Practices in the Treatment of Pulmonary Embolism and Deep Venous Thrombosis

Physician Practices in the Treatment of Pulmonary Embolism and Deep Venous Thrombosis

Association Between Antithrombotic Treatments and Prognosis of Patients With Acute Pulmonary Thromboembolism in Japan

Laboratory control of heparin therapy

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