80577
document
Heparin therapy in venous thromboembolism . Patients with pulmonary embolism or deep venous thrombosis were randomly assigned to receive either intermittent or continuous intravenous heparin therapy . In patients with an enhanced risk of bleeding , major bleeding was significantly more common during the intermittent use of heparin ; in patients without these risk factors , hemorrhage occurred with equal frequency during intermittent and continuous heparin therapy . Recurrent thromboembolism was seen significantly more often in patients receiving continuous heparin therapy . Controlling the dose of heparin with coagulation tests resulted in the administration of significantly larger daily doses of heparin with intermittent injections than with continuous infusion . Therefore , the bleeding complications of intermittent heparin therapy could have been due to the higher dose , and the recurrences associated with continuous heparin therapy may have resulted from lower doses rather than from differences in the method of administration . In a small trial , arbitrary lower doses of heparin given intermittently similar to the doses of heparin given continuously resulted in fewer bleeding complications and more recurrences . In patients without risk factors for bleeding , the intermittent administration of heparin in the higher dose is preferable because of fewer recurrences and no increase in hemorrhagic complications . In patients with a high risk of bleeding , conventional doses of heparin given continuously can reduce the rate of hemorrhagic complications but will result in more recurrences .
80578
Intervention_Pharmacological
Heparin
80579
Intervention_Pharmacological
intermittent or continuous intravenous heparin therapy
80580
Intervention_Pharmacological
continuous heparin therapy
80581
Intervention_Pharmacological
heparin
80582
Intervention_Pharmacological
heparin
80583
Outcome_Physical
bleeding
80584
Outcome_Physical
hemorrhage
80585
Outcome_Physical
Recurrent thromboembolism
80586
Outcome_Physical
bleeding complications
80587
Outcome_Physical
recurrences .
80588
Outcome_Physical
hemorrhagic complications .
80589
Outcome_Physical
rate of hemorrhagic complications