Very low doses of warfarin can prevent thrombosis in central venous catheters

Article Abstract:

The drug warfarin, or coumadin, is used to prevent thrombosis, or blood clot formation, but it can cause hemorrhage. Studies show that the use of low doses of warfarin reduce the risk of hemorrhage without affecting the antithrombotic action of warfarin. Low-dose warfarin was shown to be effective in reducing the incidence of thrombosis in veins after surgery and after the insertion of a catheter into a vein to deliver nutrient-containing fluids and medications to patients. The usefulness of low doses of this anticoagulant for preventing thrombosis was studied in patients with a central venous catheter, which was used to deliver chemotherapeutic agents. Some patients received a small dose of warfarin (one milligram) three days before catheter insertion and for the next 90 days. Another group of patients with central venous catheters did not receive warfarin. X-rays were performed on the vein with the catheter at the onset of thrombosis symptoms or at the end of 90 days. Of 42 patients receiving warfarin, four developed thrombosis with symptoms. Of 40 patients not receiving the anticoagulant, 15 patients developed thrombosis, and 10 showed symptoms of blood clotting disorders. The results demonstrate that very low doses of warfarin can protect against thrombosis without causing hemorrhage. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Thrombosis, Intravenous catheterization

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Prevention of venous thromboembolism after knee arthroplasty: a randomized, double-blind trial comparing enoxaparin with warfarin

Article Abstract:

The drug enoxaparin may be more effective than warfarin in preventing the formation of blood clots following surgery to reconstruct the knee. Researchers gave either a fixed dose of enoxaparin or a body weight-adjusted dose of warfarin to 670 patients who had undergone reconstructive knee surgery. Drugs were administered in the postoperative period. Use of enoxaparin was associated with a reduced risk of developing blood clots in the deep veins of the legs, as visualized by x-rays of the legs using radiographic contrast material. Enoxaparin reduced the relative risk of deep vein blood clots by 28.6%, and reduced the absolute risk by 14.8%. A 10% to 12% risk of developing blood clots near the surgical site was noted with use of both enoxaparin and of warfarin.

Evaluation, Anticoagulants (Medicine), Anticoagulants, Thrombophlebitis, Arthroplasty

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Pulmonary artery catheters on trial

Article Abstract:

Many physicians are arguing for a more restricted use of the Swan-Ganz catheter. This catheter, also called a pulmonary artery (PA) catheter, is inserted into the heart to monitor certain physiologic conditions. However, a 1996 study found that patients with a PA catheter had higher mortality rates than those who did not. This could be a result of the catheter itself or the catheter could be a marker of more aggressive care. Many doctors believed this type of monitoring could help patients but there is no evidence that a PA catheter leads to improved outcomes.

Usage, Arterial catheterization

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