Dalteparin - another low-molecular-weight heparin
Dalteparin (Fragmin), the second low-molecular-weight heparin since the arrival of enoxaparin, has become available to prevent deep vein thrombosis after stomach surgery. Patients risk deep vein thrombosis after major abdominal surgery especially if they are over 40 years old, obese, or have related health problems. After such surgery, only 4% of patients who received 2,500 units of dalteparin developed deep vein thrombosis compared to 16% in the group that received a placebo. Daily injections of dalteparin may be as effective as unfractionated heparin in preventing deep vein thrombosis, according to results seen in 3,800 surgery patients. Both drugs caused similar, but rare complications. Side effects include minor bleeding, hematomas at the injection site, and allergic reactions. The cost of dalteparin exceeds that of unfractionated heparin more than four-fold.
Publication Name: Medical Letter on Drugs and Therapeutics
Heparin cofactor II-proteinase reaction products exhibit neutrophil chemoattractant activity
Heparin is a medically important naturally produced molecule which acts as an anticoagulant. Heparin is assisted in this role by a glycoprotein molecule found in the blood plasma, heparin cofactor II (HCII). The exact physiologic mechanism of action of this agent is incompletely understood. Various enzymes are able to degrade HCII into smaller molecules which exhibit a different biologic function, attracting neutrophils (a type of white blood cells). The results of this experiment indicate that the enzymatic breakdown products of HCII may be an important biologic signal for initiating the acute inflammatory process, which depends in part on the migration and collection of neutrophils.
Publication Name: Blood
Improvement in heparin prophylaxis
The administration of antiobiotic and heparin prophylaxis could be substantially improved if the prophylaxis protocols are clarified sooner, possibly at the job induction stage. A list of 'at-risk' groups should be given to the nursing personnel and the pre-operative checklist should be exhaustively completed. The importance of heparin prophylaxis should also be raised through good practice, with all surgical teams adopting a uniform prophylaxis policy. Studies show antiobiotic and heparin prophylaxis are not being adequately administered in spite of a written protocol.
Publication Name: Nursing Times
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