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Latest & greatest articles for heparin
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Heparin flush for central and peripheral venous access devices Heparin flush for central and peripheral venous access devices Heparin flush for central and peripheral venous access devices Mitchell MD, Wilck MB, Zborowski K, Mull, N Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Mitchell MD, Wilck MB, Zborowski K, Mull, N. Heparin flush (...) for central and peripheral venous access devices. Philadelphia: Center for Evidence-based Practice (CEP). 2017 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Catheterization, Central Venous; Heparin; Humans Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence Center for Evidence-based Practice, University of Pennsylvania Health System, 3535 Market St. Suite 50, Philadelphia PA
Should we avoid heparin to eliminate HIT? 29296689 2018 01 03 2473-9529 1 1 2016 Nov 29 Blood advances Blood Adv Should we avoid heparin to eliminate HIT? 4 10.1182/bloodadvances.2016000083 Arepally Gowthami Morey GM Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, NC. eng Journal Article 2016 11 22 United States Blood Adv 101698425 2473-9529 Conflict-of-interest disclosure: G.M.A. has received consultancy fees from Momenta and Apotex Pharmaceuticals (...) , makers of generic low-molecular-weight heparins. 2018 1 4 6 0 2016 11 22 0 0 2016 11 22 0 1 epublish 29296689 10.1182/bloodadvances.2016000083 000083 PMC5744050
Polyphosphate/platelet factor 4 complexes can mediate heparin-independent platelet activation in heparin-induced thrombocytopenia Heparin-induced thrombocytopenia (HIT) is a thrombotic disorder initiated by antibodies to complexes between platelet factor 4 (PF4) and heparin. The risk of recurrent thromboembolism persists after heparin is cleared and platelet activation leading to release of PF4 has dissipated. We asked whether antigenic complexes between polyphosphates and PF4 released from (...) activated platelets might intensify or sustain the prothrombotic phenotype of HIT. PF4 forms stable, ultralarge complexes with polyphosphates of various sizes, including those released from platelets, which are recognized by the HIT-like monoclonal KKO, an immunoglobulin G2bκ monoclonal heparin/PF4 binding antibody, and by human HIT antibodies. KKO helps to protect PF4/polyphosphate complexes from degradation by phosphatases. Complement is activated when HIT antibodies bind to PF4/polyphosphate
Heparin for the treatment of thrombosis in neonates. Among pediatric patients, newborns are at highest risk of developing thromboembolism. Neonatal thromboembolic (TE) events may consist of both venous and arterial thromboses and often iatrogenic complications (eg, central catheterization). Treatment guidelines for pediatric patients with TE events most often are extrapolated from the literature regarding adults. Options for the management of neonatal TE events include expectant management (...) ; nitroglycerin ointment; thrombolytic therapy or anticoagulant therapy, or a combination of the two; and surgery. Since the 1990s, low molecular weight heparin (LMWH) has become the neonatal anticoagulant of choice. Reasons for its appeal include predictable dose response, no need for venous access, and limited monitoring requirements. The overall major complication rate is around 5%. Whether preterm infants are at increased risk is unclear. No data are available on the frequency of osteoporosis, heparin
Blood transfusion and filter set requirements with citrate anticoagulation compared with heparin in renal replacement therapy 28979523 2018 11 13 1751-1437 17 4 2016 Nov Journal of the Intensive Care Society J Intensive Care Soc Blood transfusion and filter set requirements with citrate anticoagulation compared with heparin in renal replacement therapy. 357 10.1177/1751143716647395 Taylor Nick N Department of Intensive Care, Royal Surrey County Hospital, Guildford, UK. Walter Edward E
Five-year outcomes following a randomized trial of femorofemoral and femoropopliteal bypass grafting with heparin-bonded or standard polytetrafluoroethylene grafts Cohort studies suggest superior long-term patency of luminal heparin-bonded polytetrafluoroethylene (Hb-PTFE) bypass grafts compared with standard PTFE grafts. The aim of this study was to compare the outcomes of Hb-PTFE grafts with those of standard PTFE grafts 5 years after a randomized trial.Patients with intermittent claudication
Bivalirudin or unfractionated heparin in patients with acute coronary syndromes managed invasively with and without ST elevation (MATRIX): randomised controlled trial. To test the optimal antithrombotic regimen in patients with acute coronary syndrome. Randomised controlled trial. Patients with acute coronary syndrome with and without ST segment elevation in 78 centres in Italy, the Netherlands, Spain, and Sweden. 7213 patients with acute coronary syndrome and planned percutaneous coronary (...) intervention: 4010 with ST segment elevation and 3203 without ST segment elevation. The primary study results in the overall population have been reported previously. Patients were randomly assigned, in an open label fashion, to one of two regimens: bivalirudin with glycoprotein IIb/IIIa inhibitors restricted to procedural complications or heparin with or without glycoprotein IIb/IIIa inhibitors. Primary endpoints were the occurrence of major adverse cardiovascular events, defined as death, myocardial
Intravenous heparin during ruptured abdominal aortic aneurysmal repair. There have been enormous advances in the screening, diagnosis, intervention and overall prognosis of abdominal aortic aneurysms (AAAs) in the last decade, but despite these, ruptured AAAs (rAAAs) still cause around 3500 to 6000 deaths in England and Wales each year. Open repair remains standard treatment for rAAA in most centres but increasingly endovascular aneurysm repair (EVAR) is being adopted. This has a 30-day (...) postoperative mortality of 40%. This has remained static despite surgical, anaesthetic and critical care advances.One significant change to current practice for elective repairs of AAAs, as opposed to emergency repairs of rAAAs, has been the introduction of intravenous heparin. This provides a protective effect against cardiac and thrombotic disease in the postoperative period. This practice has not gained widespread acceptance for emergency repairs of rAAA even though a reduction in mortality and morbidity
Increased unfractionated heparin requirements with decreasing body mass index in pregnancy Pregnant women receiving low-molecular-weight heparin for therapeutic anticoagulation are often converted to unfractionated heparin in anticipation of labor. We aim to characterize the impact of maternal body mass index on attainment of target anticoagulation during the conversion process.We conducted a five-year retrospective study of a pregnancy cohort converted from low-molecular-weight heparin (...) to unfractionated heparin in the third trimester. Patient demographics, anticoagulation regimens, and clinical outcomes were extracted from the medical record. Nonparametric statistical methods were used for analysis by body mass index (<30, 30-35, and >35).Thirty-one subjects were evenly distributed by body mass index (p = 0.97). Linear regression revealed an inverse correlation between patient body mass index and unfractionated heparin dose needed to achieve therapeutic anticoagulation (p = 0.04). Subjects
The Effect of Extended Injection of Subcutaneous Heparin on Pain Intensity and Bruising Incidence Reducing patients' pain is one of the main goals of providing clinical services, which requires nursing skill. As a simple technique, increasing the duration of subcutaneous heparin injection may affect the intensity of pain and bruising.The aim of this study was to assess the effect of increasing the heparin injection time on pain intensity and bruising associated with subcutaneous injection.The (...) present quasi-experimental study consisted of 86 patients, admitted to our hospital, who were treated with subcutaneous heparin injection. A McGill pain intensity questionnaire was used to measure pain severity in a purposive sampling. All of the subjects received subcutaneous heparin twice for 10 seconds. They also were injected twice with heparin infusion, although it was for 30 seconds this time. The interval between the two injections was 24 h, and the intensity of the pain was measured after each
Thromboprophylaxis with low molecular weight heparin versus unfractionated heparin in intensive care patients: a systematic review with meta-analysis and trial sequential analysis PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Effect of oral factor Xa inhibitor and low-molecular-weight heparin on surgical complications following total hip arthroplasty This prospective study was conducted to report the effect of oral factor Xa inhibitor and low-molecular-weight heparin (LMWH) on surgical complications following total hip arthroplasty (THA). The patients with an age < 60 years were randomly assigned to three groups (rivaroxaban, enoxaparin, and placebo) and the patients with an age ≥ 60 years were assigned to two
Heparin for Maintaining Patency of Peripherally Inserted Central Catheters in Neonates: Evidence-Based Guidelines Heparin for Maintaining Patency of Peripherally Inserted Central Catheters in Neonates: Evidence-Based Guidelines | CADTH.ca Find the information you need Heparin for Maintaining Patency of Peripherally Inserted Central Catheters in Neonates: Evidence-Based Guidelines Heparin for Maintaining Patency of Peripherally Inserted Central Catheters in Neonates: Evidence-Based Guidelines (...) Published on: November 24, 2015 Project Number: RB0937-000 Product Line: Research Type: Drug Report Type: Summary of Abstracts Result type: Report Question What are the evidence-based guidelines regarding the appropriate dose of heparin required to maintain patency of peripherally inserted central catheters (PICC) for neonatal patients? Key Message No relevant literature was identified regarding the appropriate dose of heparin required to maintain patency of peripherally inserted central catheters
Heparin-Induced Thrombocytopenia. 26535527 2015 11 06 2018 12 02 1533-4406 373 19 2015 11 05 The New England journal of medicine N. Engl. J. Med. Heparin-Induced Thrombocytopenia. 1883 10.1056/NEJMc1510993 Hoover Jon J eng Letter Comment United States N Engl J Med 0255562 0028-4793 0 Antithrombins 0 Pipecolic Acids 9005-49-6 Heparin AIM IM N Engl J Med. 2015 Jul 16;373(3):252-61 26176382 N Engl J Med. 2015 Nov 5;373(19):1883-4 26535525 Antithrombins therapeutic use Female Heparin adverse
Heparin-Induced Thrombocytopenia. 26535525 2015 11 06 2018 12 02 1533-4406 373 19 2015 11 05 The New England journal of medicine N. Engl. J. Med. Heparin-Induced Thrombocytopenia. 1883-4 10.1056/NEJMc1510993 Greinacher Andreas A eng Letter Comment United States N Engl J Med 0255562 0028-4793 0 Antithrombins 0 Pipecolic Acids 9005-49-6 Heparin AIM IM N Engl J Med. 2015 Jul 16;373(3):252-61 26176382 N Engl J Med. 2015 Nov 5;373(19):1882-3 26535526 N Engl J Med. 2015 Nov 5;373(19):1883 26535527 (...) Antithrombins therapeutic use Female Heparin adverse effects Humans Pipecolic Acids therapeutic use Thrombocytopenia chemically induced 2015 11 5 6 0 2015 11 5 6 0 2015 11 7 6 0 ppublish 26535525 10.1056/NEJMc1510993 10.1056/NEJMc1510993#SA3
Heparin-Induced Thrombocytopenia. 26535526 2015 11 06 2018 12 02 1533-4406 373 19 2015 11 05 The New England journal of medicine N. Engl. J. Med. Heparin-Induced Thrombocytopenia. 1882-3 10.1056/NEJMc1510993 Klarenbeek Naomi B NB Eikenboom Jeroen C J JC eng Letter Comment United States N Engl J Med 0255562 0028-4793 0 Antithrombins 0 Pipecolic Acids 9005-49-6 Heparin AIM IM N Engl J Med. 2015 Jul 16;373(3):252-61 26176382 N Engl J Med. 2015 Nov 5;373(19):1883-4 26535525 Antithrombins (...) therapeutic use Female Heparin adverse effects Humans Pipecolic Acids therapeutic use Thrombocytopenia chemically induced 2015 11 5 6 0 2015 11 5 6 0 2015 11 7 6 0 ppublish 26535526 10.1056/NEJMc1510993 10.1056/NEJMc1510993#SA1
Bivalirudin or Unfractionated Heparin in Acute Coronary Syndromes. Conflicting evidence exists on the efficacy and safety of bivalirudin administered as part of percutaneous coronary intervention (PCI) in patients with an acute coronary syndrome.We randomly assigned 7213 patients with an acute coronary syndrome for whom PCI was anticipated to receive either bivalirudin or unfractionated heparin. Patients in the bivalirudin group were subsequently randomly assigned to receive or not to receive (...) a post-PCI bivalirudin infusion. Primary outcomes for the comparison between bivalirudin and heparin were the occurrence of major adverse cardiovascular events (a composite of death, myocardial infarction, or stroke) and net adverse clinical events (a composite of major bleeding or a major adverse cardiovascular event). The primary outcome for the comparison of a post-PCI bivalirudin infusion with no post-PCI infusion was a composite of urgent target-vessel revascularization, definite stent
Low-molecular-weight heparin for women with unexplained recurrent pregnancy loss: a multicenter trial with a minimization randomization scheme. A daily injection of low-molecular-weight heparin (LMWH) is often prescribed to women with unexplained recurrent pregnancy loss (RPL), although evidence suggesting a benefit is questionable.To determine whether LMWH increases ongoing pregnancy and live-birth rates in women with unexplained RPL.Controlled, multicenter trial with randomization using
Association between perioperative low-molecular-weight heparin vs unfractionated heparin and clinical outcomes in patients with cancer undergoing surgery. In patients with cancer undergoing surgery, what is the association between perioperative thromboprophylaxis with low-molecular-weight heparin (LMWH) or unfractionated heparin and mortality, pulmonary embolism, deep venous thrombosis, thrombocytopenia, and bleeding outcomes?When used for perioperative thromboprophylaxis (...) , there are no differences in the association of LMWH vs unfractionated heparin for preventing mortality, pulmonary embolism, deep venous thrombosis, bleeding outcomes, or thrombocytopenia in patients with cancer.