Details
- Autor(en) / Beteiligte
- Titel
- Low molecular weight heparin and dextran in thromboprophylaxis: Human and experimental studies
- Ort / Verlag
- ProQuest Dissertations & Theses
- Erscheinungsjahr
- 1994
- Quelle
- ProQuest Dissertations & Theses A&I
- Beschreibungen/Notizen
- The antithrombotic properties and the haemostatic effect was investigated for: low molecular weight heparins (LMWHs; nadroparine (N; Fraxiparin$\sp\circler$), enoxaparin (E; Klexane$\sp\circler$), dalteparin (D; Fragmin$\sp\circler$) and tinzaparin (T; Logiparin$\sp\circler$)), dextran 70 (Dx; Macrodex$\sp\circler$) dermatan sulphate (DS; MF 701) and rec-hirudin (H; CGP 39393). Special attention was paid to the effects of the combination of LMWH and Dx. The substances were administered by i.v. The LMWHs in doses recommended by the manufacturer in thromboprophylaxis, adjusted to body weight, DS (3.0 mg/kg) and H (2.0 mg/kg) in possible antithrombotic doses. In a jugular vein thrombosis model in rabbits: (a) the antithrombotic effect of D (70 anti-Xa IU/kg), Dx (1.0 g/kg) and their combination was investigated, as well as (b) the antithrombotic effect of D (50 anti-Xa IU/kg) combined with Dx (1.0 g/kg) in relation to induction of surgical trauma, (c) the antithrombotic effect of the different LMWHs (N, E, D and T) as well as DS and H. In a haemostasis model in rats: (d) the haemostatic effect of the different substances in (c) was studied. In an experimental carotid model in sheep: (e) the effect of E (73 anti-Xa IU/kg), Dx (1.0 g/kg) and their combination on early ePTFE graft thrombogenicity was investigated. In human volunteers: (f) the effect of E and Dx (0.5 g/kg) and their combination on haemostatic parameters in plasma was investigated. Certain augmentative thromboprophylactic effects of D in combination with Dx were observed in (a) and (b). The administration of D alone or in combination with Dx, after the surgical trauma and during endothelial damage, was as effective as when administered before trauma in (b). The tested substances in (c) were all effective antithrombotics when compared with controls but with numerical differences. The same substances provoked different bleeding volume and the bleeding of the LMWHs did not correlate with either anti-IIa or -Xa plasma levels in (d). E, Dx and their combination were likewise effective in reducing early ePTFE graft thrombogenicity in (e). The results in (f) do not indicate impaired haemostasis in humans when E and Dx are combined. In conclusion: The tested substances are effective antithrombotics with individual properties and effects on haemostasis. The combination of LMWH and Dx may increase the thromboprophylactic efficacy without increased risk for bleeding complications.