Suitability of Plasma Expanders in Patients Receiving Low‐dose Heparin for Prevention of Venous Thrombosis after Surgery

Abstract

Patients (132) receiving low-dose heparin for the prevention of venous thrombosis after surgery were given in random order in addition to standard fluid therapy, a 500 ml infusion of balanced salt solution and glucose, 4% gelatine, 6% dextran, or 6% hydroxyethyl starch (mean molecular weight 40,000 or 125,000) after induction of anaesthesia. Variables of blood coagulation and haemostasis were measured before and after the operation, and peroperative bleeding tendency and postoperative bleeding complications were subjectively evaluated by the surgeon. None of the treatments significantly decreased platelet count or increased capillary bleeding time when compared to values before operation. The peroperative bleeding tendency was similar after each infusion (moderately-to-markedly increased in 18-32% of the patients). None of the patients given balanced salt solution and glucose only had postoperative bleeding complications, whereas 8-18% of patients given plasma expanders presented with such complications (plasma expanders vs no plasma expanders P less than 0.05). The results suggest that administration of gelatine, dextran or hydroxyethyl starch should be avoided in patients receiving low-dose heparin treatment for surgery.

Bleeding Risk in Interventional Pain Practice: Assessment, Management, and Review of the Literature

“…Surgical bleeding can become worse in the presence of mini-dose heparin and dextran and the combination should be avoided (67,282). This scenario may apply to percutaneous interventions, as well.…”