Low molecular weight heparin (dalteparin) in treatment of patients with thromboembolism incidents

UNLABELLED: Low molecular weight heparine (LMWH) is an established treatment for deep venous thrombosis during the initial phase of the illness as well as for prophylaxis of thrombosis. There are only few studies concerning the use of LMWH in the initial treatment of lung embolism. 138 Patients with either deep venous thrombosis at least reaching the vena poplitea and/or lung embolism have been randomised into two groups. One group was treated with unfragmented heparin. The second group received a single dose of 200 I.E./kg body weight/d LMWH (Dalteparin). The results were compared with regard to the recurrence of thrombosis and embolism, bleeding, heparin-induced thrombopenia and mortality. RESULTS: A total of 138 patients were randomised. 13 patients were excluded later. The two groups were comparable regarding age, sex, weight and diagnosis. The average treatment lasted 8.3 (5-26) days in the LMWH-group and 7.4 (4-14) days in the heparine-group. The average hospital stay was 10.4 days in the LMWH-group, and 11.0 days in the heparine-group. The complication rate was 5 (3.1%) (5 events: 3 hemorrhages, 1 reembolism, 1 death) in the LMWH-group and 4 (2.5%) (4 events: 3 bleedings, 1 sepsis of the venous catheter) in the heparine-group. We found no significant outcome difference between the two treatment groups. CONCLUSION: Weight-adapted (200 IE/kg/day) subcutaneous application of Dalteparin once daily in the treatment of patients with deep venous thrombosis or lung embolism is as safe as intravenous treatment with unfragmented heparine.