Perioperative Plasma-Antithrombinaktivität unter »Low-dose«-Heparin-Prophylaxe: Perioperativ erworbener Antithrombin-III-Mangel als Ursache für das Versagen der Heparin-Prophylaxe?

2008 ◽  
Vol 108 (12) ◽  
pp. 449-452 ◽  
Author(s):  
J. Kußmann ◽  
H. Hirche ◽  
R. Sengupta
Keyword(s):  
Low Dose ◽  
Antithrombin Iii ◽  
Dose Heparin ◽  
Low Dose Heparin

Results in Preventing Thrombosis By Low-Dose Heparin in Consideration of Heparin Concentration and Antithrombin III in

1979 ◽  
Author(s):  
V. Tilsner ◽  
U. Müller
Keyword(s):  
Low Dose ◽  
Antithrombin Iii ◽  
Factor Xa ◽  
Coagulation Factors ◽  
Optimal Dosage ◽  
Thrombin Time ◽  
Normal Limits ◽  
Dose Heparin ◽  
Treatment Plans ◽  
Low Dose Heparin

The antithrombotic effect of low-dose heparin has been ascertained clinically. The postoperative activation of the coagulation factors must be decreased, without increasing any bleeding tendencies. In order to determine the optimal dosage in low-dose heparin prophylaxis we examined the RCT, PTT, TT, Factor Xa, AT III and heparin concentrations in 400 patients prior to and following emergency surgery. Any thrombotic or haemorrhagic complication was registered. All 100 cases received one of the following treatment plans: 1) 5000 U heparin s.c. TID, 2) 7500 U heparin s.c. TID, 3) 100 U heparin/kg s.c. BID, 4) 150 U heparin/kg s.c. BID. Only plans 2 and 4 achieved a measureable heparin effect without increasing the risk of bleeding. The PTT did not shorten in either of these 2 groups and the thrombin time rose only occasionally to the upper normal limits. All other values remained within normal limits. The thrombo-embolic incidence amounted to 1% in groups 2 and 4, 2% in groups 3 and 5% in the first group.

Antithrombin III and Low-Dose Heparin in Acute Cardioembolic Stroke

1995 ◽  
Vol 5 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Masahiro Yasaka ◽  
Takenori Yamaguchi ◽  
Hideki Moriyasu ◽  
Jiro Oita ◽  
Tohru Sawada ◽  
...  
Keyword(s):  
Low Dose ◽  
Antithrombin Iii ◽  
Cardioembolic Stroke ◽  
Dose Heparin ◽  
Low Dose Heparin

Problems In Measuring Low Dose Heparin

1981 ◽  
Author(s):  
R Róka
Keyword(s):  
Low Dose ◽  
Plasma Sample ◽  
Antithrombin Iii ◽  
Platelet Factor 4 ◽  
Platelet Factor ◽  
Individual Control ◽  
Dose Heparin ◽  
The Difference ◽  
Antithrombin Iii Activity ◽  
Low Dose Heparin

In order to assess the influence of low dose heparin on the reaction between thrombin and antithrombin, an individual control is needed, if heparin levels below 0,05 U/ml are to be measured. This allows discrimination between progressive antithrombin and heparin cofactor activity. The concentration of low dose heparin is calculated as the difference between spontaneous antithrombin III activity and progressive antithrombin III activity in a given sample. The plasma sample to be assayed also serves as individual control after heparin has been inactivated by binding to platelet factor 4. Purified platelet factor 4 can either be added to the sample or liberated from platelets contained in the sample by platelet sonification. The activity of progressive antithrombin in the control depends on the ratio of thrombin to antithrombin in the reaction mixture. This ratio and the activity of progressive antithrombin increase proportionally and thus influence the calculation of low dose heparin concentration. Comparable results are obtained only if this ratio is kept constant.

Antithrombin III/Low-Dose Heparin in the Prevention of Deep-Vein Thrombosis After Total Knee Arthroplasty

1989 ◽  
Vol &NA; (248) ◽  
pp. 152???157 ◽  
Author(s):  
B. N. STULBERG ◽  
C. W. FRANCIS ◽  
V. D. PELLEGRINI ◽  
M. L. MILLER ◽  
S. SHULL ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Deep Vein Thrombosis ◽  
Knee Arthroplasty ◽  
Low Dose ◽  
Antithrombin Iii ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Total Knee ◽  
Deep Vein ◽  
Low Dose Heparin

XaI (Antithrombin III) Activity in Relation to Postoperative Deep Vein Thrombosis (DVT)

1979 ◽  
Author(s):  
I. Wallenbeck ◽  
D. Bergqvist ◽  
T. Hallböök ◽  
E.T. Yin
Keyword(s):  
Low Dose ◽  
Antithrombin Iii ◽  
Elective Surgery ◽  
Specific Test ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Comprehensive Test ◽  
Deep Vein ◽  
Antithrombin Iii Activity ◽  
Low Dose Heparin

65 patients (21 controls, 20 low-dose heparin, 24 dextran) undergoing hip or elective general surgery were tested for Xal activity with a Differential Xal Assay. The test uses activated F X as substrate for determining the biological activity of Xal in two test systems. 1) Comprehensive test measures the ability of undiluted plasma to neutralize Xa in presence of circulating accelerators or antagonists of Xal. 2) Specific test quantitates total Xal activity in a highly diluted plasma system. For screening of DVT, 125-fibrinogen and/or thermography was used. Classification into minor and major DVT was made. Mean preoperative Xal was 8-10% lower in patients who developed postoperative DVT (both tests). Hip fracture patients had significantly lower initial values than patients undergoing elective surgery (comprehensive test). Postoperatively, Xal activity in patients with minor or no DVT remained constant. In patients with major DVT, Xal activity was significantly lower (20-45% in comprehensive and 15-30% in specific test) on operation and first two postoperative days and then returned to preoperative levels. Patients who developed OVT showed the same pattern of Xal despite prophylaxis. Of 14 major DVT, 10 were diagnosed when Xal activity had normalized. This indicates that a decrease in Xal activityimmediately after trauma, can identify patients disposed to develop major thromboembolic complications.

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