[Complications of postoperative systematic preventive anticoagulant treatment]. 1989

R Rettori
Service de Chirurgie, Hôpital Corentin-Celton, CHU Necker-Enfants Malades, Issy-les-Moulineaux.

In a series of 887 cases who underwent visceral, orthopedic or vascular surgery and who received systematic post-operative prophylactic anticoagulant treatment (calciparine S.C. or in 4.8% of cases low dose heparin IV), the author reports 31 accidents (3.5%). These included 9 thromboembolic disorders with 2 deaths (0.45%) due to pulmonary embolism, 19 hemorrhagic episodes (2.14%) with 2 deaths, and 3 cases of intolerance to heparin (0.34%): 2 cases of uncomplicated thrombocytopenia and 1 case of white clot successfully treated surgically. In spite of the good results obtained as far as prevention of thromboembolic disease is concerned, this study confirms the significant frequency and severity of iatrogenic accidents. These may be reduced partly by greater care in the prescription and execution of this treatment, but it is impossible to completely avoid them; it is therefore desirable in certain cases to avoid systematic prophylactic treatment by using other first line methods such as early mobilisation, elastic contention, hemodilution or indeed in certain cases the insertion of a vena cava filter. Moreover, in 11 out of 19 patients who presented a hemorrhagic complication of heparin therapy, the insertion of such a filter was judged indispensable in order to avoid possible pulmonary embolism favored by stoppage of anticoagulant treatment.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011182 Postoperative Care The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed) Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D005260 Female Females
D006470 Hemorrhage Bleeding or escape of blood from a vessel. Bleeding,Hemorrhages
D006493 Heparin A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. Heparinic Acid,alpha-Heparin,Heparin Sodium,Liquaemin,Sodium Heparin,Unfractionated Heparin,Heparin, Sodium,Heparin, Unfractionated,alpha Heparin
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000925 Anticoagulants Agents that prevent BLOOD CLOTTING. Anticoagulant Agent,Anticoagulant Drug,Anticoagulant,Anticoagulant Agents,Anticoagulant Drugs,Anticoagulation Agents,Indirect Thrombin Inhibitors,Agent, Anticoagulant,Agents, Anticoagulant,Agents, Anticoagulation,Drug, Anticoagulant,Drugs, Anticoagulant,Inhibitors, Indirect Thrombin,Thrombin Inhibitors, Indirect
D013921 Thrombocytopenia A subnormal level of BLOOD PLATELETS. Thrombopenia,Thrombocytopenias,Thrombopenias

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