Heparin and related drugs for venous thromboembolism prophylaxis: subcutaneous or intravenous continuous infusion?

Abstract

In this article, the most evidenced approaches of unfractionated heparin administration for prevention of venous thromboembolism in medical and surgical hospitalized patients will be reviewed. Present data were collected by searching Scopus, PubMed, MEDLINE, Science direct, Clinical trials and Cochrane database systematic reviews. Subcutaneous low doses of unfractionated heparin (10000-15000 IU) in two or three divided doses per day are commonly administrated for venous thromboembolism prevention in different medical and surgical populations. In some populations such as obese surgical and critically ill patients, due to altered pharmacokinetics behavior of unfractionated heparin, continuous intravenous infusion of the low doses of unfractionated heparin has been proposed.

Comparing effects of different routes of heparin administration on the serum biomarkers of thrombosis

“…Subcutaneous (sc.) injection UFH is recommended for this purpose [6][7][8][9][10][11]. However, despite the use of the standard doses of anticoagulants, prevention of thrombosis is not desirable in some populations.…”

“…drugs in critically ill patients, the adequacy of sc. administration of UFH or LMWH for thromboprophylaxis in these patients is questionable [6]. In some recent studies, significantly lower anti-Xa levels have been detected following single daily dose of sc.…”