Avaliação da função hepática em pacientes submetidos à artroplastia total do quadril em uso de enoxaparina

Wink, Felipe Vitiello; Schwartsmann, Carlos Roberto

doi:10.1590/s0102-36162010000200007

Cited by 3 publications

(1 citation statement)

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“…18 One must emphasize that the effectiveness of these measures varies according to the patient's profile, surgical technique used, operative time, 16 patient compliance, 19 as well as their clinical evaluation, since the use of ENX causes laboratory alterations in liver function, in DHL, in 53% of the cases, albeit without clinical repercussions. 20 Thus, an effective measure in preventing VTE and reducing hospital time, in addition to reducing other adverse events, is the early The contraindication for the use of pharmacological methods was: active bleeding or active peptic ulcer, use of anticoagulation, heparin allergy or thrombocytopenia, coagulopathy (thrombocytopenia < 100,000/mm³ or NR°> 1.5), uncontrolled systemic arterial hypertension (> 180 × 110 mmHg), persistent renal failure (clearance < 30 ml/min), recent intracranial or ocular surgery < 2weeks, CSF collection in the last 24 hours. Contraindications to adjuvant methods were: concomitant open fractures, severe heart failure, peripheral arterial insufficiency of the lower limbs and infection or ulcer in the lower limbs.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Deep Venous Thrombosis Prevention in Total Hip Arthroplasty

Manfredi¹,

Machado²,

Barbato³

et al. 2021

Acta ortop. bras.

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Objective: To determine the efficacy of Deep Venous Thrombosis (DVT) prophylaxis protocol in patients undergoing total hip arthroplasty (THA), and to verify differences in the rates of this complication when comparing primary replacement surgeries with revision surgeries. Methods: We conducted a retrospective study of patients operated between 2012 and 2018, with inclusion and non-inclusion criteria determined by the researchers. A protocol was created to compile data including 92 patients, amounting to 110 operated hips, divided by gender, age, laterality, among other criteria. For THA cases, low molecular weight heparin chemoprophylaxis was used, associated with the use of pneumatic and elastic compression, concomitant to deambulation as soon as possible. The detection of DVT was determined by clinical evaluation and imaging exams such as: simple radiographs, ultrasound, arterial and venous color doppler, and laboratory tests. Results: The use of the protocol was very effective in our study. Only one (1.09%) case of deep venous thrombosis was found. Conclusion: The use of thromboprophylaxis for DVT is indispensable, as was clearly demonstrated by these cases. We observed only one (1.09%) case of DVT in our series. Level of Evidence III, Retrospective Study.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Deep Venous Thrombosis Prevention in Total Hip Arthroplasty

Manfredi¹,

Machado²,

Barbato³

et al. 2021

Acta ortop. bras.

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Comparison of the Effects of Low‐Molecular‐Weight Heparin and Fondaparinux on Liver Function in Patients With Pulmonary Embolism

Yang

Guo

et al. 2020

The Journal of Clinical Pharma

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Hepatotoxicity with low-molecular-weight heparin (LMWH) or fondaparinux is a relatively common adverse reaction. This study assessed the effects of LMWH and fondaparinux on liver function in patients with pulmonary embolism based on a retrospective cohort. As a result, a total of 463 patients with pulmonary embolism and treated with LMWH (enoxaparin sodium or nadroparin calcium) or fondaparinux sodium were included. Liver dysfunction was identified in 79 patients (17.1%), of whom 97.5% had grade 1 drug-induced liver injury (DILI) and 2.5% had grade 2 DILI. The results showed that liver dysfunction usually occurred in the first week after anticoagulant administration, and the liver tests of all patients with liver dysfunction gradually recovered or alleviated at discharge. The multivariable logistic regression analysis indicated that a longer treatment course and hepatitis B surface antigen-positive (HBsAg+) were risk factors for liver dysfunction (P < .05). Moreover, nadroparin calcium had the highest risk of liver dysfunction, approximately 2.2 times (95% confidence interval [CI], 1.1740-4.224; P = .015) that of enoxaparin sodium. In conclusion, nearly one-fifth and 10% of patients prescribed with LMWH or fondaparinux, respectively, for pulmonary embolism had liver dysfunction, mainly with mild liver injury and characterized by self-limited elevated serum transaminase levels. Hence, during the 3 anticoagulant applications, we should pay more attention to the monitoring of liver function in the first week and transit to oral anticoagulants if possible, especially for patients who are HBsAg+ or suffering from other liver diseases.

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Utility of preoperative blood screening before hip and knee arthroplasty

Shumborski

Gooden

Salmon

et al. 2020

ANZ Journal of Surgery

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Background It is engrained in medical training that routine blood screening prior to arthroplasty is necessary for optimal patient care. There is little evidence to support their utility and the aggregate cost to the health system. The purpose of this study was to evaluate preoperative blood screening by identifying the frequency of an abnormal result and to examine the influence of age, gender and body mass index on the frequency of abnormal blood pathology. Methods This is a retrospective review of 1000 patients from a single centre who underwent elective primary hip or knee arthroplasty from 2015 to 2017. Abnormal blood results were identified and clinically relevant intervals were created for routine markers. Results A total of 939 patients had available pathology results with 84% identified as having an abnormal result and 47% having a clinically important range. Abnormal liver function tests and ferritin were most common. With increasing age, there was a significant increase in rates of abnormal clinically important range, renal dysfunction, abnormal haemoglobin and erythrocyte sedimentation rate. Males and patients with body mass index >40 had an increased rate of abnormal results, particularly liver function tests. Conclusion The ordering of preoperative investigations prior to lower limb arthroplasty is recommended by the National Institute for Health and Care Excellence guidelines, alleviating concern of post‐operative complications and covering medicolegal issues. Our study determined a high frequency of abnormal results, justifying routine blood screening is recommended prior to surgery, particularly for the elderly, males and obese patients.

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Avaliação da função hepática em pacientes submetidos à artroplastia total do quadril em uso de enoxaparina

Cited by 3 publications

References 0 publications

Effectiveness of Deep Venous Thrombosis Prevention in Total Hip Arthroplasty

Effectiveness of Deep Venous Thrombosis Prevention in Total Hip Arthroplasty

Comparison of the Effects of Low‐Molecular‐Weight Heparin and Fondaparinux on Liver Function in Patients With Pulmonary Embolism

Utility of preoperative blood screening before hip and knee arthroplasty

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