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Original Research Article | OPEN ACCESS

Effects of low-molecular-weight heparin and unfractionated heparin on traumatic disseminated intravascular coagulation

Jun-Min Wen1, Yu-Xin Sun2, Xiao-Hua Pan2, Huai-Sheng Chen3

1Department of Critical Care Medicine, Shenzhen Sun Yat-Sen Cardiovascular Hospital, Shenzhen 518112; 2Department of Trauma and Orthopedic, The Second Medical College of Jinan University & Shenzhen People’s Hospital; 3Department of Critical Care Medicine, The Second Medical College of Jinan University & Shenzhen People's Hospital, Shenzhen 518020, China.

For correspondence:-  Huai-Sheng Chen   Email: jackchendoc@126.com   Tel:+8675525509566

Accepted: 17 April 2018        Published: 28 May 2018

Citation: Wen J, Sun Y, Pan X, Chen H. Effects of low-molecular-weight heparin and unfractionated heparin on traumatic disseminated intravascular coagulation. Trop J Pharm Res 2018; 17(5):961-966 doi: 10.4314/tjpr.v17i5.28

© 2018 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To explore the effects of unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) on traumatic disseminated intravascular coagulation (DIC).
Methods: A total of 77 cases of severe trauma (APACHE II score: 5 – 10) with DIC were collected and randomly assigned to one of three groups: LMWH treatment - 26 cases were subcutaneously injected with LMWH (75–150 units/kg/d); UFH treatment - 25 cases were subcutaneously injected with UFH (100 – 250 units/kg/d); control - 26 cases supplemented with blood coagulation factor only. Daily mortality in the intensive care unit (ICU), hospitalization time, bleeding rate, thrombin time, prothrombin time, activated partial thromboplastin time, and levels of fibrinogen, antithrombin III (ATIII), and D-dimer were recorded and analyzed.
Results: In ICU, LMWH and UFH treatments resulted in lower mortality than in the control group. In addition, hospitalization time was longer in patients treated with LMWH and UFH than in control patients. No significant differences were found between LMWH-treated and control patients in terms of bleeding rate, but UFH-treated patients had lower bleeding rates than control patients. Multifactor analysis indicate a strong relationship between ATIII levels and bleeding rate.
Conclusion: The results indicate that low-dose UFH and LMWH are effective options for the treatment of DIC.

Keywords: Trauma, Disseminated intravascular coagulation, Unfractionated heparin, Low-molecular-weight heparin, Fibrinogen, Antithrombin

Impact Factor
Thompson Reuters (ISI): 0.6 (2023)
H-5 index (Google Scholar): 49 (2023)

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