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Before 1933, heparin was available in small amounts, was extremely expensive and toxic, and, as a consequence, of no medical value. [21] Heparin production experienced a break in the 1990s. Until then, heparin was mainly obtained from cattle tissue, which was a by-product of the meat industry, especially in North America.
After vascular surgery, 34% of patients receiving heparin developed HIT antibodies without clinical symptoms. [15] The exact number of cases of HIT in the general population is unknown. What is known is that women receiving heparin after a recent surgical procedure, particularly cardiothoracic surgery , have a higher risk, while the risk is ...
Discontinuation of heparin is critical in a case of heparin-induced thrombocytopenia (HIT). Beyond that, however, clinicians generally treat to avoid thrombosis. [32] Treatment may include a direct thrombin inhibitor, such as lepirudin or argatroban. Other "blood thinners" sometimes used in this setting include bivalirudin and fondaparinux.
They have a rapid onset and offset of action. This means it is often possible to pause them 12 to 48 hours before surgery and resume them shortly after the surgery. By contrast, warfarin and phenprocoumon are often paused up to a week before surgery, and low-molecular-weight heparins are used to "bridge" the therapy gap, typically for several ...
Protamine sulfate is a medication that is used to reverse the effects of heparin. [3] It is specifically used in heparin overdose, in low molecular weight heparin overdose, and to reverse the effects of heparin during delivery and heart surgery. [3] [4] It is given by injection into a vein. [3] The onset of effects is typically within five ...
If a patient has had thrombolysis before, an allergy against the thrombolytic drug may have developed (especially after streptokinase). If the symptoms are mild, the infusion is stopped and the patient is commenced on an antihistamine before infusion is recommenced. Anaphylaxis generally requires immediate cessation of thrombolysis. [citation ...
Apart from using unfractionated heparin instead, it may be possible to reduce the dose and/or monitor the anti-Xa activity to guide treatment. [3] The most common side effects include bleeding, which could be severe or even fatal, allergic reactions, injection site reactions, and increases in liver enzyme tests, usually without symptoms. [13]
Ringer's lactate solution is commonly used for fluid resuscitation after blood loss due to trauma, or surgery. [9] [10]It is extensively used in aggressive volume resuscitation, e.g. for patients with pancreatitis, hemorrhagic shock or major burn injuries. [10]