Thrombosis Prophylaxis in Visceral Surgery with the Low Molecular Weight Heparin Fragment Kabi 2165 (7,500 and 2,500 Anti-Xa IU/Day)

Koller, M; Schoch, U; P, Buchmann; Largiadèr, F; Felten, A von; Pg, Frick

doi:10.1159/000215583

Cited by 6 publications

(5 citation statements)

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“…Thus, in both studies reported by Koller et al (13) and Bergqvist et al (14) using respectively 7,500 anti-Xa units and 5,000 anti-Xa units, of Kabi 2165, the high frequency of bleeding events was associated with high anti-Xa levels (mean anti-Xa levels: 0.48 and 0.60 anti-Xa unit per ml respectively).…”

Section: B L O O D Lo S S D U R In G O P E R a Ti O N (M L)mentioning

confidence: 73%

A Randomized Double-Blind Study Between a Low Molecular Weight Heparin Kabi 2165 and Standard Heparin in the Prevention of Deep Vein Thrombosis in General Surgery

Caen

1988

Thromb Haemost

103

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SummaryThe safety and efficacy of a low molecular weight heparin fragment Kabi 2165, given in the dose 2,500 anti-Xa units once daily, in preventing postoperative venous thromboembolism, was assessed against calcium heparin in the dose 5,000 IU twice daily, in a multicenter double blind randomized study. On an intention to treat basis 385 patients scheduled for major surgery were included in this study. Six patients (3.1%) out of 195 developed isotopic DVT in the Kabi 2165 group. Corresponding figures for calcium heparin was 7 patients (3.7%). There was no statistically significant difference between the two groups with respect to the bleeding variables; blood loss during operation, postoperative drainage, blood transfusion, haemoglobin and haematocrit levels; wound haematoma and haematoma at the injection sites. No patient had to undergo evacuation of wound haematoma or reoperation due to bleeding. It is concluded that one single daily injection of Kabi 2165 provides a convenient safe and effective prophylaxis against thromboembolism in general surgery.

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Section: B L O O D Lo S S D U R In G O P E R a Ti O N (M L)mentioning

confidence: 73%

A Randomized Double-Blind Study Between a Low Molecular Weight Heparin Kabi 2165 and Standard Heparin in the Prevention of Deep Vein Thrombosis in General Surgery

Caen

1988

Thromb Haemost

103

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“…The number of hemorrhagic complica tions in the fragment group seemed to be higher than the one found in the open study by Kakkar et al [3], A recent double-blind trial on LMW versus conventional low-dose heparin was stopped prematurely because of unexplainable bleeding events [171, as was the study by Roller [19] in this volume. The doses were 8,700 anti-Xa units twice daily and 7,500 anti-Xa units, respectively, which must be considered as high.…”

Section: Discussionmentioning

confidence: 91%

Prospective Double-Blind Comparison between Fragmin and Conventional Low-Dose Heparin: Thromboprophylactic Effect and Bleeding Complications

Bergqvist

Burmark

Frisell

et al. 1986

Pathophysiol Haemos Thromb

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In a randomized, prospective, double-blind multicenter trial, the effect of low-dose conventional heparin (5,000 IU/12 h) was compared to a low molecular weight (LMW) heparin fragment (5,000 antifactor Xa U/24 h). 432 patients 40 years or older undergoing elective abdominal surgery were included, 382 correctly treated. 45% had malignant diseases. The groups did not differ in risk factors. Analysis was made both on the basis of intention to treat and correct prophylaxis. No difference in results between these 2 groups was seen. Deep vein thrombosis (¹²⁵I-fibrinogen) occurred in 4.3% of the low-dose heparin group and in 6.4 of the LMW heparin group. There was a significant delay in the onset of deep vein thrombosis in the LMW heparin group. Mortality, peroperative blood loss, transfusions or infectious complications did not differ. Hemorrhagic complications occurred significantly more often in the LMW heparin group (11.6%) than in the low-dose heparin group (4.6%). Significantly fewer patients experienced local injection pain in the LMW heparin group. APTT and AT III were similar in both groups, but anti-Xa activity was significantly higher in the LMW heparin group. Single daily LMW heparin injection reduced the frequency of deep vein thrombosis to the same level as low-dose heparin twice daily. The dose or administration interval of LMW heparin in this study caused significantly more bleeding complications.

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“…The reason for this may be too short a time interval (2 h) between the preopera tive administration and the operation. In general, the subcutaneous injection of Frag min was felt to be less painful than that of standard heparin [1], Another similar investigation with Frag min in abdominal surgery was performed by Roller et al [13], He tested a once daily sub cutaneous injection of only 2,500 anti-XaU versus a twice daily administration of stan dard heparin and could demonstrate, that the antithrombotic effect was equal among the two groups even using this low dosis of Fragmin. The tolerance was also equally good.…”

Section: Prophylaxis Of Thromboembolism In General Surgerymentioning

confidence: 95%

Prophylaxis of Thromboembolism with Various Low-Molecular-Weight Heparins

Haas¹,

Blümel²

1988

Pathophysiol Haemos Thromb

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In numerous clinical studies, the antithrombotic effect and tolerance of low-molecular-weight heparins (LMWHs) were compared to those of unfractionated heparin (UFH). Based on our own experience and on a review of the literature the following conclusions can be drawn. In the field of prophylaxis of thromboembolism, including high-risk patients with major bone surgery, the antithrombotic efficacy of a single daily dose of LMWH is at least equivalent to two or three injections of UFH per day. It should, however, be noted that the margin between thromboembolic and bleeding complications has not become bigger, although this had been derived from experimental results. In order to avoid bleeding complications, it is absolutely necessary to take note of the manufacturers’ recommendations. This is particularly important when a change of various preparations is considered, because the standardization of LMWH preparations is different and the units are not comparable. The main advantage of LMWH results from an improved practicability. The single daily dose leads to an improved compliance of patients and the nursing staff is spared a great deal of work.

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Thrombosis Prophylaxis in Visceral Surgery with the Low Molecular Weight Heparin Fragment Kabi 2165 (7,500 and 2,500 Anti-Xa IU/Day)

Cited by 6 publications

References 0 publications

A Randomized Double-Blind Study Between a Low Molecular Weight Heparin Kabi 2165 and Standard Heparin in the Prevention of Deep Vein Thrombosis in General Surgery

A Randomized Double-Blind Study Between a Low Molecular Weight Heparin Kabi 2165 and Standard Heparin in the Prevention of Deep Vein Thrombosis in General Surgery

Prospective Double-Blind Comparison between Fragmin and Conventional Low-Dose Heparin: Thromboprophylactic Effect and Bleeding Complications

Prophylaxis of Thromboembolism with Various Low-Molecular-Weight Heparins

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