Lovenox Bridging Needs Paper - Zunis

CLEVELAND CLINIC JOURNAL OF MEDICINE VOLUME 70 NUMBER 11 NOVEMBER 2003973HE MORE THAN2 million patients inNorth America who take warfarin1facea major problem should they need surgery oran invasive one hand, if they continue taking war-farin up to the time of surgery, they face anincreased risk of bleeding. Therefore, mostpatients need to stop taking warfarin about 5days before surgery the time it takes for itsantithrombotic effect to wear this time and afterward, however,they may be at increased risk of thromboem-bolism, as stopping warfarin may cause arebound hypercoagulable state (which hasbeen described but not validated in clinicalpractice).2 4 Moreover, prolonged immobilityduring surgery and afterward increases the riskfor venous bridge the gap in protection againstthromboembolism, patients can receive heparinin the perioperative period, but questions aboundabout who should receive it, whether to useunfractionated heparin or one of the low-molec-ular-weight heparins, and the optimal this article we discuss: Which surgical procedures can be per-formed without stopping warfarin The optimal times to stop and restart war-farin The u

The need for bridging therapy depends on the patient’s calculated risk of thromboembolism without it, the risk of bleeding with it, and other factors. When bridging therapy is needed, we use subcutaneous doses of a low-molecular-weight heparin. Anticoagulation therapy should usually be restarted on the day after surgery. T

Tags:

  Bridging

Information

Related search queries