Prevention of Venous Thrombosis and Pulmonary Embolism in Injured Patients

Studies on Coumarin Anticoagulant Drugs

“…However, most of our subjects who received 15 24 Marcus and associates recently reported that the blood levels of digoxin in man24 and the blood and tissue levels of digoxin in the dog25 were the same by the end of 6 days whether therapy was initiated with or without a loading dose. It appears that drugs like warfarin and digoxin, which have very long biological half-lives, will accumulate sufficiently in the blood for therapeutic effect when given daily without a loading dose.…”

Diagnostic accuracy in venous thrombosis

“…The diagnosis of venous thrombosis is almost always clinical and is based on well-accepted symptoms and signs. The lack of clinical evidence of venous thrombosis in 50%O of patients dying of pulmonary embolism (Sevitt and Gallagher, 1959), however, casts doubt on the usefulness of these signs. Despite this and other supporting evidence accruing from work with precise diagnostic techniques, currently a clinical diagnosis of venous thrombosis gives the only warning of the possibility of embolism in almost all the patients at risk.…”

The Diagnosis and Management of Pulmonary Embolism

“…Although almost every patient with pulmonary embolism or pulmonary infarction has a source of thrombus formation in the venous system of the abdomen or legs, the condition will be diagnosed on the evidence in the heart or lungs. In two necropsy studies, McLachlin and Paterson (1951) found venous thrombosis in all of 19 cases of pulmonary embolism and in the series of Sevitt and Gallagher (1959) 32 of 38 patients with venous thrombosis had pulmonary embolism. Clinical methods of detecting venous thrombosis are, however, imperfect and in the absence of signs in the legs the absence of extensive thrombosis cannot be assumed.…”

“…Especially at risk are those ill with heart disease (Carlotti, Hardy, Linton and White, 1947;Short, 1952;Byrne, 1955), neoplasms (Trousseau, 1877;Sproul 1938), injuries to the bones of the legs (Sevitt and Gallagher, 1959), recent operations (Barker Nygaard, Walters and Priestley, 1940) or thrombophlebitis (Byrne, 1955). Although almost every patient with pulmonary embolism or pulmonary infarction has a source of thrombus formation in the venous system of the abdomen or legs, the condition will be diagnosed on the evidence in the heart or lungs.…”