Seminars in thrombosis and hemostasis
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Semin. Thromb. Hemost. · Jan 1993
Randomized Controlled Trial Clinical TrialLow molecular weight heparin for the prevention of thromboembolism in outpatients immobilized by plaster cast.
In an open, randomized, prospective, interindividual trial, the incidence of thrombosis with (n = 126) and without (n = 127) LMWH prophylaxis once a day was determined in 253 outpatients immobilized in a plaster cast due to an injury of the lower limb. Furthermore, the influence of possible risk factors on the thrombus formation was determined. The histories of the patients were comparable. ⋯ Crucial risk factors were age over 30 years, obesity, varicose veins, and fractures. Patients without prophylaxis who had fractures developed DVT in 29% in contrast to 11.3% in patients with soft-tissue injuries. This study shows that LMWH prophylaxis should be mandatory for plaster cast immobilized patients regardless of preexisting risk factors for thromboembolism.
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Semin. Thromb. Hemost. · Jan 1993
ReviewCoagulation and fibrinolysis in orthotopic liver transplantation: current views and insights.
Bleeding in OLT is related to two different mechanisms. There is no doubt that the extensive surgical trauma plays a critical role in the origin of serious bleeding. However, this bleeding can be aggravated by defects in the hemostasis system. ⋯ However, the effect of aprotinin and other antifibrinolytic agents has still to be confirmed by randomized clinical studies. Future scientific research should focus on the mechanisms underlying the hemostasis defects. It can be expected that these efforts may finally result in a further reduction in the usage of blood products during liver transplantation.