Low Molecular Weight Heparins and Bleeding

Hk, Breddin

doi:10.1055/s-2007-1002738

Cited by 9 publications

(5 citation statements)

References 23 publications

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“…However, they have a different spec- trum of action: low activity against thrombin is reflected in a modest effect on broad-based anticoagulant assays such as KCCT, but they have high specific activity against factor Xa (13). Studies with animal models have suggested reduced hemorrhagic potential compared with unfractionated heparin (6), which may be partly attributed to a lesser effect on platelet function (14). Human data in favor of this are sparse, but one study suggested significant shortening of venous compression time following hemodialysis (7).…”

Section: Discussionmentioning

confidence: 99%

Anticoagulation with Low Molecular Weight Heparin (Fragmin) during Continuous Hemodialysis in the Intensive Care Unit

et al. 1993

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A preparation of low molecular weight heparin (Fragmin) was administered to patients with multiorgan failure receiving continuous venovenous hemodialysis. Three patients received a high-dose regimen (35 IU/kg bolus followed by 13 IU/kg infusion), and 7 received a low-dose regimen (8 and 5 IUlkg, respectively) for 36 h. High-dose Fragmin was associated with minimal clotting in the extracorporeal circuit. Plasma fibrinopeptide A levels declined, and mean anti-Xa activity was in the range 0.47-0.79 IUlml. The urea equilibration coefficient (UEC) (100% at initiation) remained above 90% throughout. All 3 patients had mild bleeding episodes, which led to discontinuation of Fragmin in I . During all low-dose treatments, marked thrombus formation occurred in the extracorpo-

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Section: Discussionmentioning

confidence: 99%

Anticoagulation with Low Molecular Weight Heparin (Fragmin) during Continuous Hemodialysis in the Intensive Care Unit

et al. 1993

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“…Nevertheless, the validity of extrapolating the results from animal studies to the clinical setting has been questioned recently. 43 The rate of hemorrhagic complications has been highly variable among the different studies, depending on the type of LMWH preparation used and its dose. 22 Higher doses were associated with an increased risk of bleeding, and a relationship between "ex vivo" anti-Factor Xa levels and hemorrhage has been indicated.…”

Section: Tolerance To Low Molecular Weight Heparinsmentioning

confidence: 99%

Low Molecular Weight Heparins and External Pneumatic Compression as Options for Venous Thromboembolism Prophylaxis: A Surgeon's Perspective

Caprini¹,

Arcelus²,

Traverso³

et al. 1991

Semin Thromb Hemost

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“…LMWHs offer an advantage over unfractionated heparin in this respect because they are more thoroughly absorbed from a subcutaneous depot and exhibit a longer half-life allowing single daily subcutaneous administrations. rATS, which has a molecular weight similar to that of unfractionated heparin (M, _ 13,341), is absorbed at a similar rate and produces potent anticoagulant properties for a period of greater than 30 h following a single subcutaneous (29). This inconsistency may reflect the inaccessibility of fXa in the prothrombinase complex to inhibition by the LMWFUAT III conjugate as has been previously demonstrated for the heparin/AT III complex (48).…”

Section: Discussionmentioning

confidence: 96%

Anticoagulant Efficacy and Immunogenicity of the Selective Factor Xa Inhibitor Antistasin Following Subcutaneous Administration in the Rhesus Monkey

et al. 1992

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SummaryThe antithrombotic efficacy and duration of action of a single subcutaneous administration of the selective factor Xa inhibitor recombinant antistasin (rATS) was evaluated in a rhesus monkey model of mild disseminated intravascular coagulation. rATS (1 mg/kg) was shown to be fully effective and comparable to standard heparin (1,000 U/kg) in the suppression of thromboplastin-induced fibrinopeptide A generation for at least 5 h following a single subcutaneous administration. The absorption rate of rATS, as measured by ex vivo activated partial thromboplastin times (aPTT), mirrored that of standard heparin exhibiting peak anticoagulant activity between 1 and 2 h post administration. The anticoagulant effects of a single rATS dose lasted for longer than 30 h maintaining an aPTT value at least 2-fold higher than baseline. Repeated subcutaneous administrations of rATS resulted in the generation of fully neutralizing antibodies. These results suggest that specific factor Xa inhibition may be as effective as standard heparin in the treatment of venous thrombosis. Due to its antigenicity however, rATS is probably not suitable for chronic subcutaneous anticoagulant therapy.

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Low Molecular Weight Heparins and Bleeding

Cited by 9 publications

References 23 publications

Anticoagulation with Low Molecular Weight Heparin (Fragmin) during Continuous Hemodialysis in the Intensive Care Unit

Anticoagulation with Low Molecular Weight Heparin (Fragmin) during Continuous Hemodialysis in the Intensive Care Unit

Low Molecular Weight Heparins and External Pneumatic Compression as Options for Venous Thromboembolism Prophylaxis: A Surgeon's Perspective

Anticoagulant Efficacy and Immunogenicity of the Selective Factor Xa Inhibitor Antistasin Following Subcutaneous Administration in the Rhesus Monkey

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